An unusual presentation of Stewart-Treves syndrome on the lower extremity

Stewart-treves syndrome in the lower limb after arthroplasty- A case report

Stewart-Treves Syndrome is a rare and fatal condition where cutaneous angiosarcoma—a high-grade malignant tumor originating in the vascular and lymphatic endothelium—classically develops in the upper limbs post-mastectomy, with radiation therapy and axillary lymph node dissection. There are very few reports of the syndrome developing in the lower limbs, without any preceding malignancy or radiation therapy. The median development time is 11 years. Angiosarcoma originates in the vascular and lymphatic vessels, and the diagnosis is based on histopathology and immunohistochemistry findings. We report an unusual presentation of the Stewart–Treves Syndrome in an elderly female involving the lower limb with preexisting chronic lymphedema, where the tumor developed 15 months after total knee arthroplasty.

Cutaneous angiosarcoma: a case report of picking the battles in geriatrics

Cutaneous angiosarcoma (CA) is a rare form of cancer with limited treatment options and has a very severe prognosis. In this case report, a differential diagnosis, ranging from infection and neoplasia to autoimmune disease, was attributed to recurrent cellulitis centered on a purple lesion. The continuous pursuit of a diagnosis and treatment plan had to be tailored in accordance with patient goals of care. Careful anticipation of disease progression and complications was required following the diagnosis of CA and involved careful transition from palliation to hospice care. Given the aggressive nature of CA, the radical treatment required, and poor prognosis, clinical providers face a difficult task of balancing diagnostic and therapeutic steps with patient goals of care.

Stewart-Treves Syndrome on the Lower Extremity Associated to Idiopathic Chronic Lymphedema Visualized on FDG PET/CT

Angiosarcomas are highly malignant and rare tumors of vascular or lymphatic endothelial cell origin with a poor prognosis. Lymphangiosarcoma associated with chronic lymphedema is known as Stewart-Treves syndrome. Stewart-Treves syndrome is primarily described in patients with lymphedema of an upper extremity occurring after breast cancer surgery including radical axillary lymph node dissection and subsequent radiotherapy. It is rarely described in the presence of idiopathic chronic lymphedema of the lower extremities. We present a case of lymphangiosarcoma visualized on F-FDG PET/CT, where Stewart-Treves syndrome is secondary to probably a combination of idiopathic chronic lymphedema of the lower extremities and systemic immunosuppressive treatment.