Kaposi sarcoma following postmastectomy lymphedema.
Classical Kaposi sarcoma (KS) usually appears on lower extremities accompanied or preceded by local lymphedema. However, the development in areas of chronic lymphedema of the arms following mastectomy, mimicking a Stewart-Treves syndrome, has rarely been described. We report an 81-year-old woman who developed multiple, erythematous to purple tumors, located on areas of post mastectomy lymphedema. Histopathological examination evidenced several dermal nodules formed by spindle-shaped cells that delimitated slit-like vascular spaces with some red cell extravasation. Immunohistochemically, the human herpesvirus type 8 (HHV-8) latent nuclear antigen-1 was detected in the nuclei of most tumoral cells confirming the diagnosis of KS. Lymphedema could promote the development of certain tumors by altering immunocompetence. Although angiosarcoma (AS) is the most frequent neoplasia arising in the setting of chronic lymphedema, other tumors such as benign lymphangiomatous papules (BLAP) or KS can also develop in lymphedematous limbs. It is important to establish the difference between AS and KS because their prognosis and treatment are very different. Identification by immunohistochemistry of HHV-8 is useful for the distinction between KS and AS or BLAP.
Department of Dermatology and Pathology, Faculty of Medicine, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
Iria
I
Montero Pérez
Department of Dermatology and Pathology, Faculty of Medicine, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
Laura
L
Rodríguez-Pazos
Department of Dermatology and Pathology, Faculty of Medicine, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
Adriana
A
Álvarez-Pérez
Department of Dermatology and Pathology, Faculty of Medicine, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
M Mercedes Pereiro
MM
Ferreirós
Department of Dermatology and Pathology, Faculty of Medicine, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
Carlos
C
Aliste
Department of Dermatology and Pathology, Faculty of Medicine, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
Jose Manuel
JM
Suarez-Peñaranda
Department of Dermatology and Pathology, Faculty of Medicine, Complejo Hospitalario Universitario, Santiago de Compostela, Spain.
Jaime
J
Toribio
D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006394:Hemangiosarcoma / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D019288:Herpesvirus 8, Human / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008204:Lymphangiosarcoma / Q000175:diagnosis / Q000473:pathology; D008209:Lymphedema / Q000473:pathology* / Q000821:virology; D008408:Mastectomy / Q000009:adverse effects*; D012514:Sarcoma, Kaposi / Q000473:pathology* / Q000821:virology; D012878:Skin Neoplasms / Q000473:pathology / Q000821:virology; D019043:Vascular Neoplasms / Q000473:pathology* / Q000821:virology
Kaposi sarcoma; chronic lymphedema; cutaneous angiosarcoma; human herpesvirus-8; mastectomy