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Lymphangiosarcoma in a horse.

A 15-year-old Dutch Warmblood mare presented with respiratory distress and anorexia. Clinical examination revealed liquothorax and an abdominal mass. At necropsy, an infiltrating tumour was found in the visceral trunk, continuing through the diaphragm into the mediastinum. Histopathology, immunohistochemistry and electronmicroscopy showed empty channels lined by atypical endothelial cells, and neoplastic cells in a disorganized pattern, consistent with the diagnosis of a lymphangiosarcoma.

Animals↗

Long-term development of a primary lung sarcoma, probably lymphangiosarcoma--a case report.

A small primary lung lesion had remained unchanged in size over a period of 8 years. Within the ensuing 2 years rapid tumor growth occurred. On operation the surgical specimen revealed a tumor mass of 87.2 cm3. Within 6 months after resection, the tumor occurred on the same side. Extensive tumor infiltration of the chest wall prevented any further surgery. The histo-morphologic picture of both lesions was consistent with a lymphangiosarcoma without evidence of high grade malignancy. The patient died of cardio-respiratory insufficiency due to extension of the tumor mass. Unfortunately no autopsy was performed. Tumor growth rates, macroscopic reconstruction and electron microscopic evaluations are presented. This case report again points out that size and long-time stability of solitary lung nodules are not necessarily reliable criteria for assessing prognosis.

Adult↗

Stewart-Treves syndrome: lymphangiosarcoma following mastectomy.

Lymphangiosarcoma (LAS) is an aggressive, malignant vascular tumor following long-lasting chronic lymphedema. Patients with LAS demonstrate a history of breast cancer treated by radical mastectomy in the majority of patients. In the 1960s the incidence of LAS in patients with a 5-year survival after radical mastectomy varied from 0.07 to 0.45%. Today, due to changes in the operative techniques of breast cancer, less chronic lymphedema is seen with only a scant number of LAS patients. The etiology of this enigmatic tumor is not yet completely understood. Histologically, LAS arises from vascular endotheliocytes, and all vascular sarcomas originating in the setting of a chronic lymphedema are categorized as LAS. There is no standard treatment of LAS. The treatment options include radical ablative surgery, radiation therapy, and chemotherapy. The prognosis of LAS is poor; long-term survival is the exception. Only early recognition and radical surgery offer a chance of cure.

Aged↗

Postmastectomy lymphangiosarcoma: a reappraisal of the concept--a critical review and report of an illustrative case.

The syndrome of postmastectomy lymphangiosarcoma (LAS) has been universally accepted since it was first outlined by Stewart & Treves (1948), except for a small number of authors who concluded that the neoplasms arising in the chronic lymphoedematous arms were in fact due to retrograde spread from the original breast carcinoma (Laffargue, Pinet & le Go 1960, Giannardi, Pelù & Zampi 1960, Giannardi & Pelù 1961, Delarue 1962, Salm 1963, Laugier, Olmos, Hunziker & Orusco 1973), but their views have been largely ignored. A case is reported in whom neoplastic arm lesions appeared 27 years after mastectomy and were due, in our opinion, to recent metastases from a new primary Carcinoma of the lung. The validity of the entire concept of LAS is re-examined.

Adenocarcinoma↗

Electron microscopic observations of lymphangiosarcoma arising from chronic lymphedema.

Lymphangiosarcoma, so-called Stewart-Treves syndrome, originating from the edematous left leg after hysterectomy in a 53-year-old woman has been studied by light and electron microscopy. Histologically the tumor was composed of either vascular channels or solid nests of the neoplastic cells having a large hyperchromatic nucleus with a single or multiple prominent nucleoli. The inner surface of the vascular channels was lined by either single or several layers of identical cells. Erythrocytes were occasionally observed in the lumina of the vascular channels. By electron microscopy the maturation of the neoplastic cells differed considerably from one area to another even in the same section. The immature cells were clustered in groups and consisted of scanty cytoplasm and a large nucleus with prominent nucleoli, whereas some of the mature cells lining the lumina had rod-shaped tubulated bodies (Weibel-Palade bodies). Desmosomes were frequently observed between the neoplastic cells. Basal lamina was generally not continuous or not present although some vascular structures were completely surrounded by a basal lamina. An autopsy was performed but revealed no metastatic lesions in any organs or lymph nodes.

Chronic Disease↗

Lymphangiosarcoma in a chronic lymphedematous limb: a case report.

A 69-year-old-woman developed a lymphangiosarcoma of the limb on chronic lymphedema after radical mastectomy and radiotherapy for primary breast cancer 12 years before. Since 1948, when Stewart and Treves described this entity, 200 cases have been described. We report this case because of its extremely rare frequency. Concepts of etiology, treatment and prognosis are reviewed.

Arm↗

Lymphangiosarcoma in a dog.

Lymphangiosarcoma was seen in the subcutis of right chest in a 11-year-old female Poodle. No metastasis was observed clinically. Tumor cells were vimentin positive and formed irregular space or slit without erythrocytes in the tumor tissue. Lymphocytic foci and edema were seen in the stroma. Only a few tumor cells had factor VIII-related antigen. Electronmicroscopically, tumor cells did not accompany with basement membrane and intercellular junctional complex.

Animals↗

Lymphangiosarcoma in a dog treated with surgery and chemotherapy.

A large subcutaneous mass at the left cervical site in a 9-year-old male Siberian husky was removed surgically. Histopathologically, the mass was mainly consisted of a proliferation of spindle-shaped neoplastic cells arranging in solid sheath and partially vascular channels containing few blood cells. The tumor cells exhibited highly invasive activity to the surrounding tissues. In addition, the tumor cells were immunopositive for Factor VIII-related antigen. On the basis of these findings, the tumor was diagnosed as lymphangiosarcoma. Recurrent mass was noticed 3 weeks after surgery but completely disappeared after the doxorubicin treatment. Neither recurrence nor metastasis was observed for 9 months after the remission.

Animals↗

Metastatic lymphangiosarcoma in a horse.

A lymphangiosarcoma with metastases was found in a horse that presented with respiratory distress and edema in the ventral thorax and abdomen. The necropsy revealed diffuse edema in the subcutaneous connective tissue. Mediastinal, mesenteric, iliac, and renal lymph nodes were enlarged and white with soft, yellowish necrotic areas. Histologic examination revealed numerous channels and disorganized vessels lined by large polyhedral, polymorphic cells. Tumor metastases were observed in the spleen, lungs, and kidneys. Immunohistochemical evaluation of the tumor cells demonstrated positive staining for factor VIII, vimentin, and keratin. Laminin was scarce, and collagen IV staining was negative, consistent with a discontinuous or absent basement membrane.

Animals↗

Chylothorax and chylous ascites in a dog with mediastinal lymphangiosarcoma.

A 10-year-old, male toy poodle presented for evaluation of a progressively worsening, harsh, nonproductive cough. Chylous pleural effusion, lymphopenia, thrombocytopenia, normoblastemia, and recurrent subcutaneous bruising were diagnosed. Surgical exploration of the cranial mediastinum revealed extensive, redundant connective tissue which was confirmed by histopathology to be mediastinal lymphangiosarcoma (LAS). During surgical placement of a fenestrated silastic mesh for passive pleuroperitoneal drainage, chylous ascites also was diagnosed. The patient was euthanized two days postoperatively due to persistent chylothorax. The etiopathogenesis of chylothorax and chylous ascites are discussed. Previous case reports of lymphatic endothelial neoplasia are reviewed.

Animals↗

Cutaneous lymphangiosarcoma of Stewart-Treves.

Lymphangiosarcoma of an edematous extremity is a highly malignant cutaneous neoplasm seen most often ten years after a successful radical mastectomy. The sarcoma presents with an ecchymosis and/or purplish cutaneous nodules on the edematous arm; it spreads through the bloodstream and is fatal in most cases. A case is presented which shows some typical and some unusual features of this disease.

Aged↗

Lymphangiosarcoma in chronic lymphedema. Reports of 3 cases and review of the literature.

Lymphangiosarcoma is an extremely rare but highly lethal complication of chronic lymphedema. The classic clinical picture is described and three cases are presented. Current concepts of etiology, histopathology, treatment and prognosis are discussed. Since early diagnosis may be the key to longer survival, all patients with chronic lymphedema should undergo careful examination at regular intervals throughout their lives.

Aged↗

Lymphangiosarcoma in chronic hereditary oedema (Milroy's disease).

Lymphangiosarcoma arising in chronic lymphoedema is extremely rare. In a reference population of about four million people, during a thirty year period (1957-1987), only four patients were treated for such a tumour. The neoplasm is almost exclusively seen in elderly patients after mastectomy but in two of our patients, reported in this paper, it arose in chronic hereditary oedema (Milroy's disease). In both these patients there was a considerable treatment delay because of wrong diagnosis. The tumour extent was difficult to assess macroscopically and ablative surgery had to be a disarticulation of the involved extremity. Macular or papular purple lesions in a lymphoedematous extremity should be a manifestation of this aggressive neoplasm.

Adult↗

[Lymphangiosarcoma of the leg following radiotherapy for cervical carcinoma].

A case of lymphangiosarcoma of lower extremity was observed in a female aged 68 years who had had radiotherapy for cervical carcinoma. The late therapeutic result was bad, and this indicates the necessity of radical management, that is amputation in hip joint already in an early stage of the disease, although this decision is extremely difficult for the physician.

Aged↗

Lymphangiosarcoma arising from lymphangioma circumscriptum.

A lymphangiosarcoma arose at the site of a preexisting lymphangioma circumscriptum on the skin of the anterior part of the abdominal wall. To our knowledge, this is only the second such case to be reported, and in both patients, the preexisting lymphangioma circumscriptum had been exposed to substantial x-ray therapy. Since it is possible that x-irradiation may play a role in the development of this unusual malignant neoplasm, it seems advisable that lymphangioma circumscriptum not be exposed to substantial amounts of such radiation, if feasible.

Adult↗

[Lymphangiosarcoma on a chronic edema of the lower limb. Radiologic study apropos of a case].

Lymphangiosarcoma is a rare tumor of the soft tissues, in particular outside of cases where the etiology is represented by chronic edema following mastectomy for breast cancer (Stewart-Treves syndrome). In the case reported, the patient experienced chronic edema of the lower limbs, with diffuse involvement of the right leg. The sonographic appearance revealing thickening of the dermis, with localized infiltration of the aponeurosis, and especially the angiographic findings showing hypervascularization with early venous return are discussed.

Aged↗

31-P mr spectroscopy of a leg lymphangiosarcoma.

In a 64 year old man with a large, low grade lymphangiosarcoma of the right thigh, we correlated the results of in vivo 31-P-magnetic resonance spectroscopy (MRS), proton magnetic resonance imaging (MRI), and digital subtraction (DSA) with the pathologic specimen and histology. The 31-P MRS spectra of the tumor showed well-resolved peaks as follows: intense PCr (phosphocreatine), PDE (phosphodiester) and Pi (inorganic phosphate), and low PME (phosphomonoester). The Pi peak revealed an intratumor pH of 6.96 compared with 7.16 of normal skeletal muscle. The lower PME signal was consistent with low histopathologic mitotic activity of the tumor.

Angiography, Digital Subtraction↗