Stewart-Treves syndrome in a patient with elephantiasis
Identifieur interne : 000289 ( Istex/Corpus ); précédent : 000288; suivant : 000290Stewart-Treves syndrome in a patient with elephantiasis
Auteurs : Dafna Hallel-Halevy ; Joseph Yerushalmi ; Marcelo H. Grunwald ; Ilana Avinoach ; Sima HalevySource :
- Journal of the American Academy of Dermatology [ 0190-9622 ] ; 1999.
Abstract
Angiosarcoma that develops in areas of chronic lymphedema is also called Stewart-Treves syndrome. It usually appears in areas of lymphedema several years after mastectomy for breast carcinoma. Only 10% of these angiosarcomas occur in areas of chronic lymphedema as a result of another cause. We present a patient with epithelioid angiosarcoma as a rare complication of elephantiasis. (J Am Acad Dermatol 1999;41:349-50.)
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DOI: 10.1016/S0190-9622(99)70385-3
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Stewart-Treves syndrome in a patient with elephantiasis</title><author><name sortKey="Hallel Halevy, Dafna" sort="Hallel Halevy, Dafna" uniqKey="Hallel Halevy D" first="Dafna" last="Hallel-Halevy">Dafna Hallel-Halevy</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author><author><name sortKey="Yerushalmi, Joseph" sort="Yerushalmi, Joseph" uniqKey="Yerushalmi J" first="Joseph" last="Yerushalmi">Joseph Yerushalmi</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author><author><name sortKey="Grunwald, Marcelo H" sort="Grunwald, Marcelo H" uniqKey="Grunwald M" first="Marcelo H." last="Grunwald">Marcelo H. Grunwald</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author><author><name sortKey="Avinoach, Ilana" sort="Avinoach, Ilana" uniqKey="Avinoach I" first="Ilana" last="Avinoach">Ilana Avinoach</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author><author><name sortKey="Halevy, Sima" sort="Halevy, Sima" uniqKey="Halevy S" first="Sima" last="Halevy">Sima Halevy</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:06353E48159B8A3FD76C00BA0E8514D8F9F225A7</idno><date when="1999" year="1999">1999</date><idno type="doi">10.1016/S0190-9622(99)70385-3</idno><idno type="url">https://api.istex.fr/document/06353E48159B8A3FD76C00BA0E8514D8F9F225A7/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000289</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">000289</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Stewart-Treves syndrome in a patient with elephantiasis</title><author><name sortKey="Hallel Halevy, Dafna" sort="Hallel Halevy, Dafna" uniqKey="Hallel Halevy D" first="Dafna" last="Hallel-Halevy">Dafna Hallel-Halevy</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author><author><name sortKey="Yerushalmi, Joseph" sort="Yerushalmi, Joseph" uniqKey="Yerushalmi J" first="Joseph" last="Yerushalmi">Joseph Yerushalmi</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author><author><name sortKey="Grunwald, Marcelo H" sort="Grunwald, Marcelo H" uniqKey="Grunwald M" first="Marcelo H." last="Grunwald">Marcelo H. Grunwald</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author><author><name sortKey="Avinoach, Ilana" sort="Avinoach, Ilana" uniqKey="Avinoach I" first="Ilana" last="Avinoach">Ilana Avinoach</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author><author><name sortKey="Halevy, Sima" sort="Halevy, Sima" uniqKey="Halevy S" first="Sima" last="Halevy">Sima Halevy</name><affiliation><mods:affiliation>Beer-Sheva, Israel</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of the American Academy of Dermatology</title><title level="j" type="abbrev">YMJD</title><idno type="ISSN">0190-9622</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999">1999</date><biblScope unit="volume">41</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="supplement">S</biblScope><biblScope unit="page" from="349">349</biblScope><biblScope unit="page" to="350">350</biblScope></imprint><idno type="ISSN">0190-9622</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0190-9622</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Angiosarcoma that develops in areas of chronic lymphedema is also called Stewart-Treves syndrome. It usually appears in areas of lymphedema several years after mastectomy for breast carcinoma. Only 10% of these angiosarcomas occur in areas of chronic lymphedema as a result of another cause. We present a patient with epithelioid angiosarcoma as a rare complication of elephantiasis. (J Am Acad Dermatol 1999;41:349-50.)</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>angiosarcoma</json:string><json:string>lymphedema</json:string><json:string>epithelioid</json:string><json:string>elephantiasis</json:string><json:string>epithelioid angiosarcoma</json:string><json:string>chronic lymphedema</json:string><json:string>lower legs</json:string><json:string>elephantiasis nostras</json:string><json:string>prognostic factors</json:string><json:string>cellular component</json:string><json:string>abundant cytoplasm</json:string><json:string>tumor size</json:string><json:string>immunohistochemical studies</json:string><json:string>american academy</json:string><json:string>eosin stain</json:string><json:string>original magnification</json:string><json:string>recurrent episodes</json:string><json:string>rare histologic variant</json:string><json:string>multivariate analysis</json:string><json:string>angiosarcoma patients</json:string><json:string>tumor cells</json:string><json:string>lesion</json:string></teeft></keywords><author><json:item><name>Dafna Hallel-Halevy MDa</name><affiliations><json:string>Beer-Sheva, Israel</json:string></affiliations></json:item><json:item><name>Joseph Yerushalmi MDa</name><affiliations><json:string>Beer-Sheva, Israel</json:string></affiliations></json:item><json:item><name>Marcelo H. Grunwald MDa</name><affiliations><json:string>Beer-Sheva, Israel</json:string></affiliations></json:item><json:item><name>Ilana Avinoach MDb</name><affiliations><json:string>Beer-Sheva, Israel</json:string></affiliations></json:item><json:item><name>Sima Halevy MDa</name><affiliations><json:string>Beer-Sheva, Israel</json:string></affiliations></json:item></author><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Angiosarcoma that develops in areas of chronic lymphedema is also called Stewart-Treves syndrome. It usually appears in areas of lymphedema several years after mastectomy for breast carcinoma. Only 10% of these angiosarcomas occur in areas of chronic lymphedema as a result of another cause. We present a patient with epithelioid angiosarcoma as a rare complication of elephantiasis. (J Am Acad Dermatol 1999;41:349-50.)</abstract><qualityIndicators><score>1.635</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>420</abstractCharCount><pdfWordCount>891</pdfWordCount><pdfCharCount>6063</pdfCharCount><pdfPageCount>2</pdfPageCount><abstractWordCount>62</abstractWordCount></qualityIndicators><title>Stewart-Treves syndrome in a patient with elephantiasis</title><pii><json:string>S0190-9622(99)70385-3</json:string></pii><genre><json:string>research-article</json:string></genre><host><title>Journal of the American Academy of Dermatology</title><language><json:string>unknown</json:string></language><publicationDate>1999</publicationDate><issn><json:string>0190-9622</json:string></issn><pii><json:string>S0190-9622(05)X7287-5</json:string></pii><volume>41</volume><issue>2</issue><pages><first>349</first><last>350</last></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>dermatology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>dermatology & venereal diseases</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string></inist></categories><publicationDate>1999</publicationDate><copyrightDate>1999</copyrightDate><doi><json:string>10.1016/S0190-9622(99)70385-3</json:string></doi><id>06353E48159B8A3FD76C00BA0E8514D8F9F225A7</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/06353E48159B8A3FD76C00BA0E8514D8F9F225A7/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/06353E48159B8A3FD76C00BA0E8514D8F9F225A7/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/06353E48159B8A3FD76C00BA0E8514D8F9F225A7/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Stewart-Treves syndrome in a patient with elephantiasis</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>©1999 American Academy of Dermatology, Inc</p></availability><date>1999</date></publicationStmt><notesStmt><note>This supplement is made possible through an educational grant from Ortho Dermatological to the American Academy of Dermatology.</note><note>From the Department of Dermatologya and the Pathology Institute,b Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva. E-mail: dafnah@bgumail.bgu.ac.il</note><note>Reprint requests: Dafna Hallel-Halevy, MD, Department of Dermatology, Soroka University Medical Center, POB 151, Beer-Sheva, 84101 Israel.</note><note>0190-9622/99/$8.00 + 0 16/4/98280</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Stewart-Treves syndrome in a patient with elephantiasis</title><author xml:id="author-0000"><persName><forename type="first">Dafna</forename><surname>Hallel-Halevy</surname></persName><roleName type="degree">MDa</roleName><affiliation>Beer-Sheva, Israel</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Joseph</forename><surname>Yerushalmi</surname></persName><roleName type="degree">MDa</roleName><affiliation>Beer-Sheva, Israel</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Marcelo H.</forename><surname>Grunwald</surname></persName><roleName type="degree">MDa</roleName><affiliation>Beer-Sheva, Israel</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Ilana</forename><surname>Avinoach</surname></persName><roleName type="degree">MDb</roleName><affiliation>Beer-Sheva, Israel</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Sima</forename><surname>Halevy</surname></persName><roleName type="degree">MDa</roleName><affiliation>Beer-Sheva, Israel</affiliation></author><idno type="istex">06353E48159B8A3FD76C00BA0E8514D8F9F225A7</idno><idno type="DOI">10.1016/S0190-9622(99)70385-3</idno><idno type="PII">S0190-9622(99)70385-3</idno></analytic><monogr><title level="j">Journal of the American Academy of Dermatology</title><title level="j" type="abbrev">YMJD</title><idno type="pISSN">0190-9622</idno><idno type="PII">S0190-9622(05)X7287-5</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999"></date><biblScope unit="volume">41</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="supplement">S</biblScope><biblScope unit="page" from="349">349</biblScope><biblScope unit="page" to="350">350</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1999</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Angiosarcoma that develops in areas of chronic lymphedema is also called Stewart-Treves syndrome. It usually appears in areas of lymphedema several years after mastectomy for breast carcinoma. Only 10% of these angiosarcomas occur in areas of chronic lymphedema as a result of another cause. We present a patient with epithelioid angiosarcoma as a rare complication of elephantiasis. (J Am Acad Dermatol 1999;41:349-50.)</p></abstract></profileDesc><revisionDesc><change when="1999">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/06353E48159B8A3FD76C00BA0E8514D8F9F225A7/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"><istex:entity SYSTEM="gr1" NDATA="IMAGE" name="gr1"></istex:entity><istex:entity SYSTEM="gr2" NDATA="IMAGE" name="gr2"></istex:entity><istex:entity SYSTEM="gr3" NDATA="IMAGE" name="gr3"></istex:entity><istex:entity SYSTEM="gr4" NDATA="IMAGE" name="gr4"></istex:entity></istex:docType><istex:document><article docsubtype="fla" xml:lang="en"><item-info><jid>YMJD</jid><aid>98280</aid><ce:pii>S0190-9622(99)70385-3</ce:pii><ce:doi>10.1016/S0190-9622(99)70385-3</ce:doi><ce:copyright type="other" year="1999">American Academy of Dermatology, Inc</ce:copyright></item-info><head><ce:article-footnote><ce:label>☆</ce:label><ce:note-para>This supplement is made possible through an educational grant from Ortho Dermatological to the American Academy of Dermatology.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>☆☆</ce:label><ce:note-para>From the Department of Dermatology<ce:sup>a</ce:sup> and the Pathology Institute,<ce:sup>b</ce:sup> Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva. E-mail: dafnah@bgumail.bgu.ac.il</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>★</ce:label><ce:note-para>Reprint requests: Dafna Hallel-Halevy, MD, Department of Dermatology, Soroka University Medical Center, POB 151, Beer-Sheva, 84101 Israel.</ce:note-para></ce:article-footnote><ce:article-footnote><ce:label>★★</ce:label><ce:note-para>0190-9622/99/$8.00 + 0 <ce:bold>16/4/98280</ce:bold></ce:note-para></ce:article-footnote><ce:title>Stewart-Treves syndrome in a patient with elephantiasis</ce:title><ce:author-group><ce:author><ce:given-name>Dafna</ce:given-name><ce:surname>Hallel-Halevy</ce:surname><ce:degrees>MD<ce:sup>a</ce:sup></ce:degrees></ce:author><ce:author><ce:given-name>Joseph</ce:given-name><ce:surname>Yerushalmi</ce:surname><ce:degrees>MD<ce:sup>a</ce:sup></ce:degrees></ce:author><ce:author><ce:given-name>Marcelo H.</ce:given-name><ce:surname>Grunwald</ce:surname><ce:degrees>MD<ce:sup>a</ce:sup></ce:degrees></ce:author><ce:author><ce:given-name>Ilana</ce:given-name><ce:surname>Avinoach</ce:surname><ce:degrees>MD<ce:sup>b</ce:sup></ce:degrees></ce:author><ce:author><ce:given-name>Sima</ce:given-name><ce:surname>Halevy</ce:surname><ce:degrees>MD<ce:sup>a</ce:sup></ce:degrees></ce:author><ce:affiliation><ce:textfn>Beer-Sheva, Israel</ce:textfn></ce:affiliation></ce:author-group><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para>Angiosarcoma that develops in areas of chronic lymphedema is also called Stewart-Treves syndrome. It usually appears in areas of lymphedema several years after mastectomy for breast carcinoma. Only 10% of these angiosarcomas occur in areas of chronic lymphedema as a result of another cause. We present a patient with epithelioid angiosarcoma as a rare complication of elephantiasis. (J Am Acad Dermatol 1999;41:349-50.)</ce:simple-para></ce:abstract-sec></ce:abstract></head><body><ce:sections><ce:section><ce:section-title>CASE REPORT</ce:section-title><ce:para>A 64-year-old woman known to suffer from recurrent erysipelas with chronic leg lymphedema of 30 years duration was referred because of a rapidly growing lesion on the lower leg, which appeared 3 months earlier. Past history revealed mild leucopenia, mild diabetes mellitus, and epilepsy treated with phenobarbital and phenytoin tablets. On examination, marked enlargement with nonpitting edema, compatible with elephantiasis nostras, was observed in both lower legs, accompanied by skin-colored papules of lymphangiectases (Fig 1).
<ce:display><ce:figure id="fig1"><ce:label>Fig. 1</ce:label><ce:caption><ce:simple-para>Lower legs: elephantiasis nostras, lymphangiectases, and purple crusted nodule on left shin.</ce:simple-para></ce:caption> <ce:link locator="gr1"></ce:link></ce:figure></ce:display>A 10-cm wide purple, nodular, erosive, and partly crusted lesion was situated on her left shin. Similar purple, satellite lesions appeared around the central nodule (<ce:cross-ref refid="fig1">Figs 1</ce:cross-ref> and 2).
<ce:display><ce:figure><ce:label>Fig. 2</ce:label><ce:caption><ce:simple-para>Ulcerated purple nodule with similar satellite lesions— closer view.</ce:simple-para></ce:caption> <ce:link locator="gr2"></ce:link></ce:figure></ce:display>Physical examination was unremarkable except for obesity. A surgical biopsy specimen obtained from the lesion revealed an ulcerated malignant vascular tumor with 2 major components, vascular and cellular (Figs 3 and 4).
<ce:display><ce:figure><ce:label>Fig. 3</ce:label><ce:caption><ce:simple-para>Histologic picture of lesion showing tumor with vascular and cellular components. (Hematoxylin and eosin stain; original magnification, ×200.)</ce:simple-para></ce:caption> <ce:link locator="gr3"></ce:link></ce:figure></ce:display><ce:display><ce:figure id="fig4"><ce:label>Fig. 4</ce:label><ce:caption><ce:simple-para>Cellular component of tumor showed large epithelioid cells with abundant cytoplasm, large nucleus, and bizarre mitoses. (Hematoxylin and eosin stain; original magnification ×1000.)</ce:simple-para></ce:caption> <ce:link locator="gr4"></ce:link></ce:figure></ce:display>The cellular component was composed of solid sheets of large atypical epithelioid tumor cells with abundant cytoplasm, large nuclei and prominent eosinophilic nucleoli. Numerous atypical mitoses were present in the tumor cells (<ce:cross-ref refid="fig4">Fig 4</ce:cross-ref>). The vascular component was composed of irregular distorted vascular channels of different sizes, lined by atypical plump malignant and endothelial cells. Large areas of necrosis and foci of hemorrhages were present in the tumor. Immunohistochemical studies revealed positive expression of factor VIII, CD-34 (human hematoprogenitor cell antigen), Ulex europaeus agglutinin I Ag, vimentin and keratin. Electron microscopic examination of the tumor cells showed cytoplasmic tubular structures, consisting of Weible palade bodies, characteristic of vascular endothelium. The clinical and laboratory findings were consistent with angiosarcoma (lymphangiosarcoma). Routine blood tests and extensive work-up, including imaging techniques (chest and left leg radiographs, bone scan, computerized tomography of the chest, legs, abdomen, and abdominal ultrasound) failed to reveal extracutaneous involvement. The patient underwent above-the-knee amputation.</ce:para></ce:section><ce:section><ce:section-title>DISCUSSION</ce:section-title><ce:para>Sarcomas of the soft tissues account for less than 1% of all the malignant tumors. Angiosarcomas comprise only 2% of all the sarcomas.<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup></ce:cross-ref> Sixty percent of angiosarcomas appear in the skin or superficial soft tissues.<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup></ce:cross-ref> Cutaneous angiosarcoma, generally appears in older men in the head and neck region, or rarely, after radiation or in areas of chronic lymphedema, usually after mastectomy. Only 10% are due to lymphedema or other causes, eg, trauma, congenital factors, postsurgical obstruction, filiariasis, “arm chair” type of lymphedema, and idiopathic factors,<ce:cross-refs refid="bib1 bib2 bib3"><ce:sup>1-3</ce:sup></ce:cross-refs> including recurrent episodes of cellulitis<ce:cross-ref refid="bib4"><ce:sup>4</ce:sup></ce:cross-ref> as in this case.</ce:para><ce:para>Angiosarcoma appearing in areas of lymphedema is also called lymphangiosarcoma; however, immunohistochemical and ultrastructural studies support a hemangiomatous differentiation.<ce:cross-ref refid="bib2"><ce:sup>2</ce:sup></ce:cross-ref> It is a high grade malignant tumor with a mean survival time of 19 to 34 months.<ce:cross-ref refid="bib2"><ce:sup>2</ce:sup></ce:cross-ref> The current case showed a rare histologic variant: epithelioid angiosarcoma that histologically mimics epithelial neoplasms. It has a preference for the lower legs, but clinically, is otherwise indistinguishable from conventional angiosarcoma. Immunohistochemical studies of epithelioid angiosarcoma demonstrates expression of endothelial and cytokeratin markers. There are conflicting reports concerning prognosis.<ce:cross-ref refid="bib2"><ce:sup>2</ce:sup></ce:cross-ref> Angiosarcomas tend to recur locally and metastasize, despite aggressive combination therapy. Because of its multifocality and its unapparent subclinical spread, it is hard to make a complete excision. Naka et al,<ce:cross-ref refid="bib5"><ce:sup>5</ce:sup></ce:cross-ref> in a multivariate analysis of 55 angiosarcoma patients, have found that tumor size (greater than 5 cm in diameter), treatment modality, eg, surgery alone versus multimodal treatment (marginal or wide local excision, or amputation followed by chemotherapy with or without radiation), and number of mitoses (greater than 10 per 10 high power fields) are independent grave prognostic factors.<ce:cross-ref refid="bib5"><ce:sup>5</ce:sup></ce:cross-ref> A retrospective study<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup></ce:cross-ref> of 67 angiosarcoma patients found that excision combined with radiotherapy has the best chance of controlling the tumor. The role of the chemotherapy is not yet clear. Mark et al<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup></ce:cross-ref> have also found that tumor size, grade, and site are prognostic factors.</ce:para><ce:para>We have presented a patient with a rare histologic variant of epithelioid angiosarcoma as a complication of elephantiasis, most probably after recurrent episodes of erysipelas of both legs.</ce:para></ce:section></ce:sections></body><tail><ce:bibliography><ce:section-title>References</ce:section-title><ce:bibliography-sec><ce:bib-reference 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Oncol</sb:maintitle></sb:title><sb:volume-nr>61</sb:volume-nr></sb:series><sb:date>1996</sb:date></sb:issue><sb:pages><sb:first-page>170</sb:first-page><sb:last-page>176</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference></ce:bibliography-sec></ce:bibliography></tail></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Stewart-Treves syndrome in a patient with elephantiasis</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Stewart-Treves syndrome in a patient with elephantiasis</title></titleInfo><name type="personal"><namePart type="given">Dafna</namePart><namePart type="family">Hallel-Halevy</namePart><namePart type="termsOfAddress">MDa</namePart><affiliation>Beer-Sheva, Israel</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joseph</namePart><namePart type="family">Yerushalmi</namePart><namePart type="termsOfAddress">MDa</namePart><affiliation>Beer-Sheva, Israel</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marcelo H.</namePart><namePart type="family">Grunwald</namePart><namePart type="termsOfAddress">MDa</namePart><affiliation>Beer-Sheva, Israel</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ilana</namePart><namePart type="family">Avinoach</namePart><namePart type="termsOfAddress">MDb</namePart><affiliation>Beer-Sheva, Israel</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sima</namePart><namePart type="family">Halevy</namePart><namePart type="termsOfAddress">MDa</namePart><affiliation>Beer-Sheva, Israel</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1999</dateIssued><copyrightDate encoding="w3cdtf">1999</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Angiosarcoma that develops in areas of chronic lymphedema is also called Stewart-Treves syndrome. It usually appears in areas of lymphedema several years after mastectomy for breast carcinoma. Only 10% of these angiosarcomas occur in areas of chronic lymphedema as a result of another cause. We present a patient with epithelioid angiosarcoma as a rare complication of elephantiasis. (J Am Acad Dermatol 1999;41:349-50.)</abstract><note>This supplement is made possible through an educational grant from Ortho Dermatological to the American Academy of Dermatology.</note><note>From the Department of Dermatologya and the Pathology Institute,b Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva. E-mail: dafnah@bgumail.bgu.ac.il</note><note>Reprint requests: Dafna Hallel-Halevy, MD, Department of Dermatology, Soroka University Medical Center, POB 151, Beer-Sheva, 84101 Israel.</note><note>0190-9622/99/$8.00 + 0 16/4/98280</note><relatedItem type="host"><titleInfo><title>Journal of the American Academy of Dermatology</title></titleInfo><titleInfo type="abbreviated"><title>YMJD</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">199908</dateIssued></originInfo><identifier type="ISSN">0190-9622</identifier><identifier type="PII">S0190-9622(05)X7287-5</identifier><part><date>199908</date><detail type="volume"><number>41</number><caption>vol.</caption></detail><detail type="issue"><number>2</number><caption>no.</caption></detail><detail type="supplement"><number>S</number><caption>Suppl.</caption></detail><extent unit="issue pages"><start>285</start><end>364</end></extent><extent unit="pages"><start>349</start><end>350</end></extent></part></relatedItem><identifier type="istex">06353E48159B8A3FD76C00BA0E8514D8F9F225A7</identifier><identifier type="DOI">10.1016/S0190-9622(99)70385-3</identifier><identifier type="PII">S0190-9622(99)70385-3</identifier><accessCondition type="use and reproduction" contentType="copyright">©1999 American Academy of Dermatology, Inc</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>American Academy of Dermatology, Inc, ©1999</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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