Pretibial Located Stewart-Treves Syndrome: Uncommon Presentation in a Bulgarian Patient!

  • Georgi Tchernev Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, General Skobelev Nr 79, Sofia 1606 Bulgaria; Onkoderma - Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26, Sofia 1407
  • Irina Yungareva Medical Institute of the Ministry of Interior, Department of Dermatology and Venereology, Skobelev bul. 79, Sofia 1606
  • Hristo Mangarov Medical Institute of the Ministry of Interior, Dermatology, Venereology and Dermatologic Surgery, Lozenets Plachkovica number 5, Sofia 1164
  • Konstantin Stavrov Medical Institute of the Ministry of Interior, Dermatology and Dermatologic Surgery, Sofia
  • Ilia Lozev Medical Institute of the Ministry of Interior, Surgery, Sofia
  • Ivanka Temelkova Medical Institute of the Ministry of Interior, Dermatology, Venereology and Dermatologic Surgery Sofia, Sofia
  • Svetoslav Chernin Medical Institute of the Ministry of Interior, Common, vascular and abdominal Surgery Stoletov #2, Sofia, Sofia 1612
  • Ivan Pidakev Medical Institute of Ministry of Interior, Department of Common, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia
  • Michael Tronnier Helios Klinikum GMBH - Dermatology, Venereology and Allergology, Hildesheim
Keywords: (HHV-8), Angiosarcoma, Epithelioid variant, Stewart Treves syndrome, Surgery, Amputation

Abstract

BACKGROUND: The Stewart-Treves syndrome with localisation in the region of the lower extremities is not something unusual as clinical pathology, but the clinical diagnostics is rather difficult, and it can be further complicated maximally because of: the similar locoregional findings in patients with other cutaneous malignancies.

CASE REPORT: Presented is a rare form of an epithelioid variant of the Stewart Treves syndrome in a woman, aged 81, localised in the region of the lower leg and significantly advanced only for 2 months. The diagnosis was confirmed histologically and immunohistochemically. Amputation of the affected extremity was planned. Discussed are important etiopathogenetic aspects regarding the approach in patients with lymphedema and possibility for development of the Stewart Treves syndrome.

CONCLUSION: Analyzing the evidence from the literature worldwide, we concluded that perhaps the only reliable (to some extent) therapeutic option in patients with Stewart Treves Syndrome is 1) the early diagnostics and 2) the following inevitable radical excision or amputation with the maximal field of surgical security in the proximal direction.

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References

Pereira ES, Moraes ET, Siqueira DM, Santos MA. Stewart Treves Syndrome. An Bras Dermatol. 2015; 90(3 Suppl 1):229-31. https://doi.org/10.1590/abd1806-4841.20153685 PMid:26312725 PMCid:PMC4540559

Sharma A, Schwartz RA. Stewart Treves syndrome: pathogenesis and management. J Am Acad Dermatol. 2012; 67:1342–1348. https://doi.org/10.1016/j.jaad.2012.04.028 PMid:22682884

Stanczyk M, Gewartowska M, Swierkowski M, Grala B, Maruszynski M. Stewart Treves syndrome angiosarcoma express phenotypes of both blood and lymphatic capillaries. Chin Med J (Engl). 2013; 126:231–237.

Aguiar Bujanda D, Camacho Galán R, Bastida I-area J, Aguiar Morales J, Conde Martel A, Rivero Suárez P, et al. Angiosarcoma of the abdominal wall after dermolipectomy in a morbidly obese man. A rare form of presentation of Stewart Treves syndrome. Eur J Dermatol. 2006; 16:290–292. PMid:16709497

Iga N, Endo Y, Fujisawa A, Matsumura Y, Kabashima K, Tanioka M, et al. Two cases of cutaneous angiosarcoma developed after breast cancer surgery. Case Rep Dermatol. 2012; 4:247–249. https://doi.org/10.1159/000345559 PMid:23275768 PMCid:PMC3531937

Kunkel T, Mylonas I, Mayr D, Friese K, Sommer HL. Recurrence of secondary in a patient with postradiated breast for breast cancer. Arch Gynecol Obstet. 2008; 278:497–501. https://doi.org/10.1007/s00404-008-0605-8 PMid:18305948

Berebichez-Fridman R, Deutsch YE, Joyal TM, Olvera PM, Benedetto PW, Rosenberg AE, Kett DH. Stewart-Treves Syndrome: A Case Report and Review of the Literature. Case Rep Oncol. 2016; 9(1): 205–211. https://doi.org/10.1159/000445427

PMid:27099606 PMCid:PMC4836142

Young RJ, Brown JN, Reed MW, Hughes D, Woll PJ. Angiosarcoma. Lancet Oncol. 2010; 11:983–991. https://doi.org/10.1016/S1470-2045(10)70023-1

Tabareau F, de Muret A, Miquelestorena E, Decouvelaere AV, de Pinieux G. Cutaneous epithelioid clear cells angiosarcoma in a aoung woman with congenital lymphedema. Case Rep Pathol. 2013; 1:1–6. https://doi.org/10.1155/2013/931973 PMid:24078891 PMCid:PMC3776547

Shon W, Ida CM, Boland-Froemming JM, Rose PS, Folpe A. Cutaneous angiosarcoma arising in massive localized lymphedema of the morbidly obese: a report of five cases and review of the literature. J Cutan Pathol. 2011; 38:560–564. https://doi.org/10.1111/j.1600-0560.2011.01703.x PMid:21518378

Published
2018-04-14
How to Cite
1.
Tchernev G, Yungareva I, Mangarov H, Stavrov K, Lozev I, Temelkova I, Chernin S, Pidakev I, Tronnier M. Pretibial Located Stewart-Treves Syndrome: Uncommon Presentation in a Bulgarian Patient!. Open Access Maced J Med Sci [Internet]. 2018Apr.14 [cited 2021Jan.27];6(4):663-5. Available from: https://www.id-press.eu/mjms/article/view/oamjms.2018.191
Section
C- Case Reports