Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis
Identifieur interne : 000808 ( Main/Exploration ); précédent : 000807; suivant : 000809Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis
Auteurs : Shelley J. E. Hwang [Australie] ; Benjamin Y. Kong [Australie] ; Shaun Chou [Australie] ; Deepal Wakade [Australie] ; Matteo S. Carlino [Australie] ; Pablo Fernandez-Penas [Australie]Source :
- Case Reports in Medicine [ 1687-9627 ] ; 2017.
Abstract
There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event.
Url:
DOI: 10.1155/2017/5462929
PubMed: 28182109
PubMed Central: 5274679
Affiliations:
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E." last="Hwang">Shelley J. E. Hwang</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Dermatology, Westmead Hospital, Westmead, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Dermatology, Westmead Hospital, Westmead, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Sydney Medical School, The University of Sydney, Sydney, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Medical School, The University of Sydney, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Kong, Benjamin Y" sort="Kong, Benjamin Y" uniqKey="Kong B" first="Benjamin Y." last="Kong">Benjamin Y. Kong</name><affiliation wicri:level="1"><nlm:aff id="I3">Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Chou, Shaun" sort="Chou, Shaun" uniqKey="Chou S" first="Shaun" last="Chou">Shaun Chou</name><affiliation wicri:level="1"><nlm:aff id="I4">Department of Tissue Pathology, Westmead Hospital, Westmead, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Tissue Pathology, Westmead Hospital, Westmead, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Wakade, Deepal" sort="Wakade, Deepal" uniqKey="Wakade D" first="Deepal" last="Wakade">Deepal Wakade</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Dermatology, Westmead Hospital, Westmead, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Dermatology, Westmead Hospital, Westmead, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Sydney Medical School, The University of Sydney, Sydney, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Medical School, The University of Sydney, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Carlino, Matteo S" sort="Carlino, Matteo S" uniqKey="Carlino M" first="Matteo S." last="Carlino">Matteo S. Carlino</name><affiliation wicri:level="1"><nlm:aff id="I2">Sydney Medical School, The University of Sydney, Sydney, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Medical School, The University of Sydney, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I5">Melanoma Institute Australia, Sydney, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Melanoma Institute Australia, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author><author><name sortKey="Fernandez Penas, Pablo" sort="Fernandez Penas, Pablo" uniqKey="Fernandez Penas P" first="Pablo" last="Fernandez-Penas">Pablo Fernandez-Penas</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Dermatology, Westmead Hospital, Westmead, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Dermatology, Westmead Hospital, Westmead, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Sydney Medical School, The University of Sydney, Sydney, NSW, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Sydney Medical School, The University of Sydney, Sydney, NSW</wicri:regionArea><wicri:noRegion>NSW</wicri:noRegion></affiliation></author></analytic><series><title level="j">Case Reports in Medicine</title><idno type="ISSN">1687-9627</idno><idno type="eISSN">1687-9635</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event. </p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Starritt, E C" uniqKey="Starritt E">E. C. Starritt</name></author><author><name sortKey="Joseph, D" uniqKey="Joseph D">D. Joseph</name></author><author><name sortKey="Mckinnon, J G" uniqKey="Mckinnon J">J. G. McKinnon</name></author><author><name sortKey="Lo, S K" uniqKey="Lo S">S. K. Lo</name></author><author><name sortKey="De Wilt, J H W" uniqKey="De Wilt J">J. H. W. de Wilt</name></author><author><name sortKey="Thompson, J F" uniqKey="Thompson J">J. F. Thompson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Damian, D L" uniqKey="Damian D">D. L. Damian</name></author><author><name sortKey="Saw, R P M" uniqKey="Saw R">R. P. M. Saw</name></author><author><name sortKey="Thompson, J F" uniqKey="Thompson J">J. F. 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Lass</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ridner, S H" uniqKey="Ridner S">S. H. Ridner</name></author><author><name sortKey="Murphy, B" uniqKey="Murphy B">B. Murphy</name></author><author><name sortKey="Deng, J" uniqKey="Deng J">J. Deng</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ridner, S H" uniqKey="Ridner S">S. H. Ridner</name></author><author><name sortKey="Murphy, B" uniqKey="Murphy B">B. Murphy</name></author><author><name sortKey="Deng, J" uniqKey="Deng J">J. Deng</name></author><author><name sortKey="Kidd, N" uniqKey="Kidd N">N. Kidd</name></author><author><name sortKey="Galford, E" uniqKey="Galford E">E. Galford</name></author><author><name sortKey="Dietrich, M S" uniqKey="Dietrich M">M. S. Dietrich</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Carlino, M S" uniqKey="Carlino M">M. S. Carlino</name></author><author><name sortKey="Gowrishankar, K" uniqKey="Gowrishankar K">K. Gowrishankar</name></author><author><name sortKey="Saunders, C A B" uniqKey="Saunders C">C. A. B. Saunders</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Australie</li></country></list><tree><country name="Australie"><noRegion><name sortKey="Hwang, Shelley J E" sort="Hwang, Shelley J E" uniqKey="Hwang S" first="Shelley J. E." last="Hwang">Shelley J. E. Hwang</name></noRegion><name sortKey="Carlino, Matteo S" sort="Carlino, Matteo S" uniqKey="Carlino M" first="Matteo S." last="Carlino">Matteo S. Carlino</name><name sortKey="Carlino, Matteo S" sort="Carlino, Matteo S" uniqKey="Carlino M" first="Matteo S." last="Carlino">Matteo S. Carlino</name><name sortKey="Carlino, Matteo S" sort="Carlino, Matteo S" uniqKey="Carlino M" first="Matteo S." last="Carlino">Matteo S. Carlino</name><name sortKey="Chou, Shaun" sort="Chou, Shaun" uniqKey="Chou S" first="Shaun" last="Chou">Shaun Chou</name><name sortKey="Fernandez Penas, Pablo" sort="Fernandez Penas, Pablo" uniqKey="Fernandez Penas P" first="Pablo" last="Fernandez-Penas">Pablo Fernandez-Penas</name><name sortKey="Fernandez Penas, Pablo" sort="Fernandez Penas, Pablo" uniqKey="Fernandez Penas P" first="Pablo" last="Fernandez-Penas">Pablo Fernandez-Penas</name><name sortKey="Hwang, Shelley J E" sort="Hwang, Shelley J E" uniqKey="Hwang S" first="Shelley J. E." last="Hwang">Shelley J. E. Hwang</name><name sortKey="Kong, Benjamin Y" sort="Kong, Benjamin Y" uniqKey="Kong B" first="Benjamin Y." last="Kong">Benjamin Y. Kong</name><name sortKey="Wakade, Deepal" sort="Wakade, Deepal" uniqKey="Wakade D" first="Deepal" last="Wakade">Deepal Wakade</name><name sortKey="Wakade, Deepal" sort="Wakade, Deepal" uniqKey="Wakade D" first="Deepal" last="Wakade">Deepal Wakade</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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