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Sarcomas
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
This is the name given to the rare development of a lymphangiosarcoma in the upper limbs of women with chronic lymphoedema secondary to the treatment of breast carcinoma. Treatment can be difficult owing to the pre-existing oedema and associated postoperative and postradiotherapy changes. Amputation might be necessary.
Sarcomas
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Tumors of vascular endothelial origin—include angiosarcoma, lymphangiosarcoma, and hemangiopericytoma. Angiosarcomas are common in elderly people in the scalp. They also do occur in the skin, breast, and the liver (Figure 1). Vinyl chloride exposure has been blamed as etiological factor. They have a spongy or blood blister appearance. Lymphangiosarcoma is a rare tumor that used to be frequently seen in the arms of patients who underwent a radical mastectomy and radiation therapy. It arises in a long standing lymphatic obstruction of 10 to 20 years (Figure 2). The survival is poor and lung metastases are common. Hemangiopericytomas do occur in all age groups and sites, but mainly in the lower extremities and retroperitoneum and pelvis. Histologically, this tumor may mimic synovial sarcoma.
Lower limb
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Lymphangiosarcoma may develop >10 years following the onset of lymphoedema and carries a poor prognosis. Stewart–Treves syndrome is lymphangiosarcoma developing in a lymphoedematous arm following mastectomy.
Chemotherapy and targeted treatments of breast sarcoma by histologic subtype
Published in Expert Review of Anticancer Therapy, 2021
Stefania Kokkali, Athina Stravodimou, Jose Duran-Moreno, Nektarios Koufopoulos, Ioannis a Voutsadakis, Antonia Digklia
The incidence of angiosarcoma varies between 7% and 41% in the largest series of primary breast sarcomas (Table 1). It is described in young women without history of BC or irradiation and in older women following RT for primary BC [21]. Its incidence seems quite low, though, after breast-conserving treatment for BC. Marchal et al. reviewed approximately 20,000 patients’ records treated for primary BC within 11 French Comprehensive Cancer Centers and found a prevalence of 5 angiosarcomas per 10.000, approaching that of the general population [84]. A larger retrospective analysis of more than 200,000 women treated for BC was also published, using the SEER database [85]. A prevalence of 3.2/1000 and 2.3/1000 was reported for patients who did not receive and those who received RT, respectively, considering all BS. Of them, angiosarcomas represented only 5.7% of BS in the group without prior RT and 56.8% in the radiation-induced group. An approximate 12-fold increased risk of chest wall or breast angiosarcoma was reported in a case-control study of patients with a history of RT for BC [86]. Furthermore, the same study revealed a 60-fold increased risk of upper extremity lymphangiosarcoma and only a 3-fold increased risk of other sarcomas. With the increase of breast-conserving surgery for BC the incidence of radiation-induced angiosarcoma would be expected to increase. However, radiation techniques improved over time, sparing normal tissue, and therefore it is unknown how this incidence will be affected.
An accidental finding of a giant intra-abdominal mass
Published in Acta Chirurgica Belgica, 2023
Jonathan Mertens, Ann Driessen, Niels Komen
Mesenteric cysts are intra-abdominal tumours that can grow to prodigious proportions. They can occur anywhere in the mesentery, radiating from the duodenum to the rectum [9]. Mesenteric cysts were first described by the Italian anatomist Benivieni in 1507 during an autopsy, while Tillaux performed the first successful resection of a mesenteric cyst in 1880 [16]. Most mesenteric cysts are benign, but malignant transformations into lymphangiosarcoma, teratoma or adenocarcinoma are described in approximately 3% of cases [1,3,5,6]. The exact etiology of mesenteric cysts remains undecided. They are possibly the result of failure of ectopic lymph nodes to communicate with the remainder of the lymphatic or venous system. This phenomenon can develop due to lymphatic malformation, neoplasm, occult trauma or infection [4,17]. Mesenteric cysts most commonly originate from the small bowel mesentery, followed by the mesocolon and retroperitoneum [2,4,6]. Uncommonly they originate from the sigmoid mesentery [18]. Mesenteric cysts can appear as simple or multiple lesions that are uni- or multilocular. Their content can be hemorrhagic, serous or chylous [4]. Mesenteric cysts are very rare, with incidence rates estimated around 1 per 100 000 to 250 000 adult subjects, but this is probably an underestimation due to underdiagnosis [1–3,19,20]. Most patients are asymptomatic or present with non-specific symptoms such as abdominal pain, unexplained weight gain, nausea, vomiting, constipation or diarrhea. However, complications like torsion, rupture, hemorrhage or compression of surrounding tissues can be life-threatening, prompting swift surgical management [9].
Exercise oncology: an emerging discipline in the cancer care continuum
Published in Postgraduate Medicine, 2022
Ga Watson, Zl Coyne, E Houlihan, Gd Leonard
Lymphedema is an excessive accumulation of excess protein-rich interstitial fluid within tissues caused by lymphatic insufficiency. Lymphedema can result in adverse events such as skin break-down and infection, and rarely development of a secondary malignancy such as lymphangiosarcoma. Lymphedema can also significantly impair activities of daily living by causing a restriction in range of motion, pain, and increased skin tension, all of which impacts QOL [97]. Physical exercise has been shown to be effective as both a treatment and a prevention strategy for lymphedema [98].