LymphedemaV1, Pmc, Corpus, bibRecord, 002231

Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer

Identifieur interne : 002231 ( Pmc/Corpus ); précédent : 002230; suivant : 002232

Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer

Source :

Indian Journal of Dermatology [ 0019-5154 ] ; 2015.

RBID : PMC:4318044

Abstract

Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318044

DOI: 10.4103/0019-5154.147880
PubMed: 25657438
PubMed Central: 4318044

Links to Exploration step

PMC:4318044

Le document en format XML

<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer</title>
<author><name sortKey="Rao, Angoori Gnaneshwar" sort="Rao, Angoori Gnaneshwar" uniqKey="Rao A" first="Angoori Gnaneshwar" last="Rao">Angoori Gnaneshwar Rao</name>
<affiliation><nlm:aff id="aff1"></nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25657438</idno>
<idno type="pmc">4318044</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318044</idno>
<idno type="RBID">PMC:4318044</idno>
<idno type="doi">10.4103/0019-5154.147880</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">002231</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002231</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer</title>
<author><name sortKey="Rao, Angoori Gnaneshwar" sort="Rao, Angoori Gnaneshwar" uniqKey="Rao A" first="Angoori Gnaneshwar" last="Rao">Angoori Gnaneshwar Rao</name>
<affiliation><nlm:aff id="aff1"></nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Indian Journal of Dermatology</title>
<idno type="ISSN">0019-5154</idno>
<idno type="eISSN">1998-3611</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.</p>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Plotnick, H" uniqKey="Plotnick H">H Plotnick</name>
</author>
<author><name sortKey="Richfield, D" uniqKey="Richfield D">D Richfield</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Leshin, B" uniqKey="Leshin B">B Leshin</name>
</author>
<author><name sortKey="Whitaker, Dc" uniqKey="Whitaker D">DC Whitaker</name>
</author>
<author><name sortKey="Foucar, E" uniqKey="Foucar E">E Foucar</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Celis, Av" uniqKey="Celis A">AV Celis</name>
</author>
<author><name sortKey="Gaughf, Cn" uniqKey="Gaughf C">CN Gaughf</name>
</author>
<author><name sortKey="Sangueza, Op" uniqKey="Sangueza O">OP Sangueza</name>
</author>
<author><name sortKey="Gourdin, Fw" uniqKey="Gourdin F">FW Gourdin</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Giannelli, V" uniqKey="Giannelli V">V Giannelli</name>
</author>
<author><name sortKey="Rockley, Pf" uniqKey="Rockley P">PF Rockley</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mallett, Rb" uniqKey="Mallett R">RB Mallett</name>
</author>
<author><name sortKey="Curley, Gk" uniqKey="Curley G">GK Curley</name>
</author>
<author><name sortKey="Mortimer, Ps" uniqKey="Mortimer P">PS Mortimer</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Moon, Se" uniqKey="Moon S">SE Moon</name>
</author>
<author><name sortKey="Youn, Ji" uniqKey="Youn J">JI Youn</name>
</author>
<author><name sortKey="Lee, Ys" uniqKey="Lee Y">YS Lee</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ziv, R" uniqKey="Ziv R">R Ziv</name>
</author>
<author><name sortKey="Schewach Millet, M" uniqKey="Schewach Millet M">M Schewach-Millet</name>
</author>
<author><name sortKey="Trau, H" uniqKey="Trau H">H Trau</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Di Leonardo, M" uniqKey="Di Leonardo M">M Di Leonardo</name>
</author>
<author><name sortKey="Jacoby, Ra" uniqKey="Jacoby R">RA Jacoby</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tuffanelli, Dl" uniqKey="Tuffanelli D">DL Tuffanelli</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Garcia Doval, I" uniqKey="Garcia Doval I">I García-Doval</name>
</author>
<author><name sortKey="De La Torre, C" uniqKey="De La Torre C">C de la Torre</name>
</author>
<author><name sortKey="Losada, A" uniqKey="Losada A">A Losada</name>
</author>
<author><name sortKey="Ocampo, C" uniqKey="Ocampo C">C Ocampo</name>
</author>
<author><name sortKey="Rodriguez, T" uniqKey="Rodriguez T">T Rodríguez</name>
</author>
<author><name sortKey="Cruces, Mj" uniqKey="Cruces M">MJ Cruces</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chiyomaru, K" uniqKey="Chiyomaru K">K Chiyomaru</name>
</author>
<author><name sortKey="Nishigori, C" uniqKey="Nishigori C">C Nishigori</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Stewart, Cj" uniqKey="Stewart C">CJ Stewart</name>
</author>
<author><name sortKey="Chan, T" uniqKey="Chan T">T Chan</name>
</author>
<author><name sortKey="Platten, M" uniqKey="Platten M">M Platten</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Gnanaraj, P" uniqKey="Gnanaraj P">P Gnanaraj</name>
</author>
<author><name sortKey="Revathy, V" uniqKey="Revathy V">V Revathy</name>
</author>
<author><name sortKey="Venugopal, V" uniqKey="Venugopal V">V Venugopal</name>
</author>
<author><name sortKey="Tamilchelvan, D" uniqKey="Tamilchelvan D">D Tamilchelvan</name>
</author>
<author><name sortKey="Rajagopalan, V" uniqKey="Rajagopalan V">V Rajagopalan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tasdelen, I" uniqKey="Tasdelen I">I Tasdelen</name>
</author>
<author><name sortKey="Gokgoz, S" uniqKey="Gokgoz S">S Gokgoz</name>
</author>
<author><name sortKey="Paksoy, E" uniqKey="Paksoy E">E Paksoy</name>
</author>
<author><name sortKey="Yerci, O" uniqKey="Yerci O">O Yerci</name>
</author>
<author><name sortKey="Cetintas, Sk" uniqKey="Cetintas S">SK Cetintas</name>
</author>
<author><name sortKey="Demiray, M" uniqKey="Demiray M">M Demiray</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kaya, Ti" uniqKey="Kaya T">TI Kaya</name>
</author>
<author><name sortKey="Kokturk, A" uniqKey="Kokturk A">A Kokturk</name>
</author>
<author><name sortKey="Polat, A" uniqKey="Polat A">A Polat</name>
</author>
<author><name sortKey="Tursen, U" uniqKey="Tursen U">U Tursen</name>
</author>
<author><name sortKey="Ikizoglu, G" uniqKey="Ikizoglu G">G Ikizoglu</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jappe, U" uniqKey="Jappe U">U Jappe</name>
</author>
<author><name sortKey="Zimmermann, T" uniqKey="Zimmermann T">T Zimmermann</name>
</author>
<author><name sortKey="Kahle, B" uniqKey="Kahle B">B Kahle</name>
</author>
<author><name sortKey="Petzoldt, D" uniqKey="Petzoldt D">D Petzoldt</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mortimer, Ps" uniqKey="Mortimer P">PS Mortimer</name>
</author>
<author><name sortKey="Simmonds, Rh" uniqKey="Simmonds R">RH Simmonds</name>
</author>
<author><name sortKey="Rezvani, M" uniqKey="Rezvani M">M Rezvani</name>
</author>
<author><name sortKey="Robbins, Me" uniqKey="Robbins M">ME Robbins</name>
</author>
<author><name sortKey="Ryan, Tj" uniqKey="Ryan T">TJ Ryan</name>
</author>
<author><name sortKey="Hopewell, Jw" uniqKey="Hopewell J">JW Hopewell</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jackowski, S" uniqKey="Jackowski S">S Jackowski</name>
</author>
<author><name sortKey="Janusch, M" uniqKey="Janusch M">M Janusch</name>
</author>
<author><name sortKey="Fiedler, E" uniqKey="Fiedler E">E Fiedler</name>
</author>
<author><name sortKey="Marsch, Wc" uniqKey="Marsch W">WC Marsch</name>
</author>
<author><name sortKey="Ulbrich, Ej" uniqKey="Ulbrich E">EJ Ulbrich</name>
</author>
<author><name sortKey="Gaisbauer, G" uniqKey="Gaisbauer G">G Gaisbauer</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rodriguez Bujald N, A" uniqKey="Rodriguez Bujald N A">A Rodríguez-Bujaldón</name>
</author>
<author><name sortKey="Vazquez Bayo, Mc" uniqKey="Vazquez Bayo M">MC Vázquez-Bayo</name>
</author>
<author><name sortKey="Galan Gutierrez, M" uniqKey="Galan Gutierrez M">M Galán-Gutiérrez</name>
</author>
<author><name sortKey="Jimenez Puya, R" uniqKey="Jimenez Puya R">R Jiménez-Puya</name>
</author>
<author><name sortKey="Velez, Garcia Nieto A" uniqKey="Velez G">García-Nieto A Vélez</name>
</author>
<author><name sortKey="Moreno Gimenez, Jc" uniqKey="Moreno Gimenez J">JC Moreno-Giménez</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Manner, J" uniqKey="Manner J">J Manner</name>
</author>
<author><name sortKey="Radlwimmer, B" uniqKey="Radlwimmer B">B Radlwimmer</name>
</author>
<author><name sortKey="Hohenberger, P" uniqKey="Hohenberger P">P Hohenberger</name>
</author>
<author><name sortKey="Mossinger, K" uniqKey="Mossinger K">K Mössinger</name>
</author>
<author><name sortKey="Kuffer, S" uniqKey="Kuffer S">S Küffer</name>
</author>
<author><name sortKey="Sauer, C" uniqKey="Sauer C">C Sauer</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bailin, Pl" uniqKey="Bailin P">PL Bailin</name>
</author>
<author><name sortKey="Kantor, Gr" uniqKey="Kantor G">GR Kantor</name>
</author>
<author><name sortKey="Wheeland, Rg" uniqKey="Wheeland R">RG Wheeland</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Weingold, Dh" uniqKey="Weingold D">DH Weingold</name>
</author>
<author><name sortKey="White, Pf" uniqKey="White P">PF White</name>
</author>
<author><name sortKey="Burton, Cs" uniqKey="Burton C">CS Burton</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Khunger, N" uniqKey="Khunger N">N Khunger</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
  <front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Dermatol</journal-id>
<journal-id journal-id-type="iso-abbrev">Indian J Dermatol</journal-id>
<journal-id journal-id-type="publisher-id">IJD</journal-id>
<journal-title-group><journal-title>Indian Journal of Dermatology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0019-5154</issn>
<issn pub-type="epub">1998-3611</issn>
<publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name>
<publisher-loc>India</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25657438</article-id>
<article-id pub-id-type="pmc">4318044</article-id>
<article-id pub-id-type="publisher-id">IJD-60-106d</article-id>
<article-id pub-id-type="doi">10.4103/0019-5154.147880</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>E-IJD Case Report</subject>
</subj-group>
</article-categories>
<title-group><article-title>Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Rao</surname>
<given-names>Angoori Gnaneshwar</given-names>
</name>
<xref ref-type="aff" rid="aff1"></xref>
<xref ref-type="corresp" rid="cor1"></xref>
</contrib>
</contrib-group>
<aff id="aff1"><italic>From the Department of Dermatology, SVS Medical College, Mahbubnagar, Andhra Pradesh, India</italic>
</aff>
<author-notes><corresp id="cor1"><italic><bold>Address for correspondence:</bold>
 Prof. Angoori Gnaneshwar Rao, Department of Dermatology, SVS Medical College Mahbubnagar, Andhra Pradesh, India. E-mail: <email xlink:href="dr_a_g_rao@yahoo.co.in">dr_a_g_rao@yahoo.co.in</email>
</italic>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><season>Jan-Feb</season>
<year>2015</year>
</pub-date>
<volume>60</volume>
<issue>1</issue>
<fpage seq="d">106</fpage>
<lpage>106</lpage>
<history><date date-type="received"><month>12</month>
<year>2012</year>
</date>
<date date-type="accepted"><month>3</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>Copyright: © Indian Journal of Dermatology</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.</p>
</abstract>
<kwd-group><kwd><italic>Acquired lymphagiectasia</italic>
</kwd>
<kwd><italic>lymphedema</italic>
</kwd>
<kwd><italic>radiation</italic>
</kwd>
<kwd><italic>surgery</italic>
</kwd>
</kwd-group>
</article-meta>
</front>
<body><boxed-text position="float"><p><bold>What was known?</bold>
</p>
<p>Acquired lymphangiectasia is known to occur following surgery and/or radiotherapy for carcinoma breast. It is usually associated with lymphedema.</p>
</boxed-text>
<sec sec-type="intro" id="sec1-1"><title>Introduction</title>
<p>Acquired lymphangiectasia (AL) is a dilation of lymphatic vessels, which results after damage caused to the previously normal lymphatics. The damage can primarily be due to surgical intervention alone, irradiation alone, or by surgery and irradiation combined or secondary to scarring. In 1956, Plotnick and Richfield first described it as a complication of radical mastectomy.[<xref rid="ref1" ref-type="bibr">1</xref>
] AL most commonly occurs in adults as a late sequel of surgery and radiation therapy (RT). It has also been associated with metastatic lymph node invasion and obstruction. AL clinically manifests as translucent vesicles in a chronic lymphedematous area several years after surgery with or without RT.[<xref rid="ref2" ref-type="bibr">2</xref>
]</p>
</sec>
<sec id="sec1-2"><title>Case Report</title>
<p>A 40-year-old woman was reported with multiple vesicles and bullae on the front and right side of the chest for 2 years. She was diagnosed as a case of infiltrating duct cell carcinoma of the right breast in the year 2006 for which she underwent radical mastectomy followed by the radiotherapy. She noticed the vesicular eruption 4 years after surgery and radiotherapy. Cutaneous examination revealed the absence of the right breast (post mastectomy). Multiple grouped vesicles and bullae were spread over the right anterior, lateral wall of the chest, and the hypochondrium. A Y-shaped scar was noticed in the middle of the right mammary region (mastectomy scar) with no evidence of lymphedema underneath [<xref ref-type="fig" rid="F1">Figure 1</xref>
]. Few of the vesicles and bullae were purple in color; pedunculated, and hypertrophic [<xref ref-type="fig" rid="F2">Figure 2</xref>
]. The clinical findings prompted us to diagnose AL. However, lymphangioma circumscriptum (LC), lymphangiomatous cutaneous metastases, and angiosarcoma were considered in the differential diagnosis. Histopathological examination of skin biopsy revealed, numerous dilated lymphatics in the superficial and papillary dermis lined by flattened endothelial cells, with mild hyperkeratosis consistent with diagnosis of lymphangiectasia [Figures <xref ref-type="fig" rid="F3">3</xref>
 and <xref ref-type="fig" rid="F4">4</xref>
]. Immunohistochemistry with podoplanin (specific marker for lymphatic endothelium) could not be carried out due to paucity of funds. She was managed with electrodessication.</p>
<fig id="F1" position="float"><label>Figure 1</label>
<caption><p>Multiple grouped vesicles and bullae on the right mammary region and lateral wall of chest and right hypochondrium</p>
</caption>
<graphic xlink:href="IJD-60-106d-g001"></graphic>
</fig>
<fig id="F2" position="float"><label>Figure 2</label>
<caption><p>Purple and translucent vesicles and hypertrophic pedunculated bullae</p>
</caption>
<graphic xlink:href="IJD-60-106d-g002"></graphic>
</fig>
<fig id="F3" position="float"><label>Figure 3</label>
<caption><p>Histopathology skin showing numerous dilated lymphatics in the superficial and papillary dermis (H and E, ×10)</p>
</caption>
<graphic xlink:href="IJD-60-106d-g003"></graphic>
</fig>
<fig id="F4" position="float"><label>Figure 4</label>
<caption><p>Histopathology skin showing dilated lymphatics in the superficial and papillary dermis lined by flattened endothelial cells with mild hyperkeratosis (H and E, ×40)</p>
</caption>
<graphic xlink:href="IJD-60-106d-g004"></graphic>
</fig>
</sec>
<sec sec-type="discussion" id="sec1-3"><title>Discussion</title>
<p>AL represents acquired vesicular dilation of lymphatic channels secondary to an external cause. It has been reported in the literature with an increased frequency in the past 20 years due to increase in surgical excision, surgery and RT for certain malignancies of breast and cervix.[<xref rid="ref3" ref-type="bibr">3</xref>
<xref rid="ref4" ref-type="bibr">4</xref>
<xref rid="ref5" ref-type="bibr">5</xref>
] AL was also reported as a sequel to the treatment of myxoid chondrosarcoma and bronchial carcinoid.[<xref rid="ref6" ref-type="bibr">6</xref>
<xref rid="ref7" ref-type="bibr">7</xref>
] It characteristically presents with the vesicles and bullae. Some of these may turn purple due to the presence of red cells, which arise from hemangiolymphatic connections. Occasionally, they may become pedunculated with the hyperkeratotic and verrucous surface resembling wart. The index case is presented with similar features. Coexisting lymphedema is a usual association in most patients of AL. However, there was no associated lymphedema in the reported case. It is usually asymptomatic, but trauma may provide portal of entry for infection giving rise to recurrent cellulitis.[<xref rid="ref3" ref-type="bibr">3</xref>
] Scarring from scrofuloderma, scleroderma, and cirrhosis are also known to cause AL without lymphedema.[<xref rid="ref8" ref-type="bibr">8</xref>
<xref rid="ref9" ref-type="bibr">9</xref>
<xref rid="ref10" ref-type="bibr">10</xref>
] Chiyomaru and Nishigor in a retrospective study of 73 cases of AL following treatment for malignant neoplasm notified external genitalia as the most frequent site. Furthermore, they reported that the combination of surgery and irradiation (77%) was the most frequent preceding therapy, followed by surgery alone (18%) and irradiation alone (5%). In addition, it was found that the mean interval from completion of therapy to the development of AL was shorter after combination therapy (5.8 years) than after surgery (12.2 years) or irradiation (11.8 years) alone.[<xref rid="ref11" ref-type="bibr">11</xref>
] Stewart <italic>et al</italic>
., have also reported AL in their study of 8 patients of carcinoma cervix following surgery and/or radiotherapy.[<xref rid="ref12" ref-type="bibr">12</xref>
] Gnanraj <italic>et al</italic>
., have also notified two cases of AL following surgery and radiotherapy for carcinoma cervix.[<xref rid="ref13" ref-type="bibr">13</xref>
] AL has been reported to occur 3-26 years after the surgery,[<xref rid="ref12" ref-type="bibr">12</xref>
<xref rid="ref13" ref-type="bibr">13</xref>
<xref rid="ref14" ref-type="bibr">14</xref>
<xref rid="ref15" ref-type="bibr">15</xref>
<xref rid="ref16" ref-type="bibr">16</xref>
] [<xref ref-type="table" rid="T1">Table 1</xref>
]. The index case developed AL 4 years after surgery and radiotherapy, which is relatively short, compared to the other studies in the literature.</p>
<table-wrap id="T1" position="float"><label>Table 1</label>
<caption><p>Interval between therapy and development of lymphangiectasia in various case studies</p>
</caption>
<graphic xlink:href="IJD-60-106d-g005"></graphic>
</table-wrap>
<p>The pathogenesis of AL is unclear; however, surgical damage most likely causes fibrosis and lymphatic obstruction at the base of the reticular dermis and accumulation of lymph fluid in the dermal lymphatics with resultant increased pressure. This can then lead to dilation of the superficial lymphatic channels with subsequent vesicle formation. RT also contributes in its pathogenesis because the main site of injury of RT is at the junction of the fat and reticular dermis.,[<xref rid="ref5" ref-type="bibr">5</xref>
<xref rid="ref17" ref-type="bibr">17</xref>
] RT itself is known to cause lymphangiectasia by causing lymphangiogenesis in the exposed area during the 1<sup>st</sup>
 year of therapy. Recently, it was found that there was an increased number of podoplanin-positive lymphatic vessels and CD68-positive histiocytes in cancer patients treated with the radiotherapy.[<xref rid="ref18" ref-type="bibr">18</xref>
] AL patients with the chronic lymphedema following mastectomy and/or radiotherapy may develop angiosarcoma.[<xref rid="ref19" ref-type="bibr">19</xref>
] These angiosarcomas are characterized immunohistochemically by expression and amplification of myelocytomatosis (MYC) gene, which differentiates post radiation angiosarcomas from benign vascular proliferations following radiotherapy.[<xref rid="ref20" ref-type="bibr">20</xref>
] In addition, immunohistochemical staining for MYC not only helps in the diagnosis but also helps in mapping the neoplasm.</p>
<p>AL is indistinguishable both clinically and histopathologically from LC. Histologically, both reveal ectatic lymphatic spaces in the papillary dermis, which are lined by normal or flattened endothelial cells. The overlying epidermis may show hyperkeratosis and acanthosis. Although, there are no histological criteria to differentiate LC from AL some believe that the subcutaneous muscle-coated cisternae characteristic of LC are absent in AL.</p>
<p>Various therapeutic modalities have been advocated for the treatment of lymphangiectasis. These include surgical excision, cryotherapy, electrodesiccation, sclerotherapy, and laser therapy.[<xref rid="ref3" ref-type="bibr">3</xref>
<xref rid="ref4" ref-type="bibr">4</xref>
<xref rid="ref5" ref-type="bibr">5</xref>
] Various types of lasers have been used for the treatment including the carbondioxide,[<xref rid="ref21" ref-type="bibr">21</xref>
] argon and tunable dye.[<xref rid="ref22" ref-type="bibr">22</xref>
] The combination of radiofrequency ablation with sclerotherapy was found to be simple, efficacious and cost-effective with a long-term satisfactory results.[<xref rid="ref23" ref-type="bibr">23</xref>
] Gianelli and Rockley found electrodessication superior to the other treatment modalities.[<xref rid="ref4" ref-type="bibr">4</xref>
] Each therapeutic option is effective, but recurrences are common and may be complicated by scarring.</p>
<boxed-text position="float"><p><bold>What is new?</bold>
</p>
<p>AL without lymphedema is known to occur following scarring in scrofuloderma, scleroderma, and cirrhosis. The absence of lymphedema in the reported case of AL without an underlying disease is novel and interesting. The short time interval between the treatment (surgery and radiotherapy) and the development of AL is noteworthy in the reported case.</p>
</boxed-text>
</sec>
</body>
<back><fn-group><fn fn-type="supported-by"><p><bold>Source of support:</bold>
 Nil</p>
</fn>
<fn fn-type="conflict"><p><bold>Conflict of Interest:</bold>
 Nil.</p>
</fn>
</fn-group>
<ref-list><ref id="ref1"><label>1</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Plotnick</surname>
<given-names>H</given-names>
</name>
<name><surname>Richfield</surname>
<given-names>D</given-names>
</name>
</person-group>
<article-title>Tuberous lymphangiectatic varices secondary to radical mastectomy</article-title>
<source>Arch Dermatol</source>
<year>1956</year>
<volume>74</volume>
<fpage>466</fpage>
<lpage>8</lpage>
</element-citation>
</ref>
<ref id="ref2"><label>2</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Leshin</surname>
<given-names>B</given-names>
</name>
<name><surname>Whitaker</surname>
<given-names>DC</given-names>
</name>
<name><surname>Foucar</surname>
<given-names>E</given-names>
</name>
</person-group>
<article-title>Lymphangioma circumscriptum following mastectomy and radiation therapy</article-title>
<source>J Am Acad Dermatol</source>
<year>1986</year>
<volume>15</volume>
<fpage>1117</fpage>
<lpage>9</lpage>
<pub-id pub-id-type="pmid">3771862</pub-id>
</element-citation>
</ref>
<ref id="ref3"><label>3</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Celis</surname>
<given-names>AV</given-names>
</name>
<name><surname>Gaughf</surname>
<given-names>CN</given-names>
</name>
<name><surname>Sangueza</surname>
<given-names>OP</given-names>
</name>
<name><surname>Gourdin</surname>
<given-names>FW</given-names>
</name>
</person-group>
<article-title>Acquired lymphangiectasis</article-title>
<source>South Med J</source>
<year>1999</year>
<volume>92</volume>
<fpage>69</fpage>
<lpage>72</lpage>
<pub-id pub-id-type="pmid">9932832</pub-id>
</element-citation>
</ref>
<ref id="ref4"><label>4</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Giannelli</surname>
<given-names>V</given-names>
</name>
<name><surname>Rockley</surname>
<given-names>PF</given-names>
</name>
</person-group>
<article-title>Acquired lymphangiectasis following mastectomy and radiation therapy: Report of a case and review of the literature</article-title>
<source>Cutis</source>
<year>1996</year>
<volume>58</volume>
<fpage>276</fpage>
<lpage>8</lpage>
<pub-id pub-id-type="pmid">8894426</pub-id>
</element-citation>
</ref>
<ref id="ref5"><label>5</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mallett</surname>
<given-names>RB</given-names>
</name>
<name><surname>Curley</surname>
<given-names>GK</given-names>
</name>
<name><surname>Mortimer</surname>
<given-names>PS</given-names>
</name>
</person-group>
<article-title>Acquired lymphangioma: Report of four cases and a discussion of the pathogenesis</article-title>
<source>Br J Dermatol</source>
<year>1992</year>
<volume>126</volume>
<fpage>380</fpage>
<lpage>2</lpage>
<pub-id pub-id-type="pmid">1571261</pub-id>
</element-citation>
</ref>
<ref id="ref6"><label>6</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Moon</surname>
<given-names>SE</given-names>
</name>
<name><surname>Youn</surname>
<given-names>JI</given-names>
</name>
<name><surname>Lee</surname>
<given-names>YS</given-names>
</name>
</person-group>
<article-title>Acquired cutaneous lymphangiectasia</article-title>
<source>Br J Dermatol</source>
<year>1993</year>
<volume>129</volume>
<fpage>193</fpage>
<lpage>5</lpage>
<pub-id pub-id-type="pmid">7654584</pub-id>
</element-citation>
</ref>
<ref id="ref7"><label>7</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ziv</surname>
<given-names>R</given-names>
</name>
<name><surname>Schewach-Millet</surname>
<given-names>M</given-names>
</name>
<name><surname>Trau</surname>
<given-names>H</given-names>
</name>
</person-group>
<article-title>Lymphangiectasia. A complication of thoracotomy for bronchial carcinoid</article-title>
<source>Int J Dermatol</source>
<year>1988</year>
<volume>27</volume>
<fpage>123</fpage>
<pub-id pub-id-type="pmid">3360554</pub-id>
</element-citation>
</ref>
<ref id="ref8"><label>8</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Di Leonardo</surname>
<given-names>M</given-names>
</name>
<name><surname>Jacoby</surname>
<given-names>RA</given-names>
</name>
</person-group>
<article-title>Acquired cutaneous lymphangiectasias secondary to scarring from scrofuloderma</article-title>
<source>J Am Acad Dermatol</source>
<year>1986</year>
<volume>14</volume>
<fpage>688</fpage>
<lpage>90</lpage>
<pub-id pub-id-type="pmid">3958285</pub-id>
</element-citation>
</ref>
<ref id="ref9"><label>9</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tuffanelli</surname>
<given-names>DL</given-names>
</name>
</person-group>
<article-title>Letter: Lymphangiectasis due to scleroderma</article-title>
<source>Arch Dermatol</source>
<year>1975</year>
<volume>111</volume>
<fpage>1216</fpage>
<pub-id pub-id-type="pmid">1167061</pub-id>
</element-citation>
</ref>
<ref id="ref10"><label>10</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>García-Doval</surname>
<given-names>I</given-names>
</name>
<name><surname>de la Torre</surname>
<given-names>C</given-names>
</name>
<name><surname>Losada</surname>
<given-names>A</given-names>
</name>
<name><surname>Ocampo</surname>
<given-names>C</given-names>
</name>
<name><surname>Rodríguez</surname>
<given-names>T</given-names>
</name>
<name><surname>Cruces</surname>
<given-names>MJ</given-names>
</name>
</person-group>
<article-title>Acquired cutaneous lymphangiectasia in a patient with cirrhotic ascites</article-title>
<source>J Eur Acad Dermatol Venereol</source>
<year>1999</year>
<volume>13</volume>
<fpage>109</fpage>
<lpage>12</lpage>
<pub-id pub-id-type="pmid">10568489</pub-id>
</element-citation>
</ref>
<ref id="ref11"><label>11</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chiyomaru</surname>
<given-names>K</given-names>
</name>
<name><surname>Nishigori</surname>
<given-names>C</given-names>
</name>
</person-group>
<article-title>Acquired lymphangiectasia associated with treatment for preceding malignant neoplasm: A retrospective series of 73 Japanese patients</article-title>
<source>Arch Dermatol</source>
<year>2009</year>
<volume>145</volume>
<fpage>841</fpage>
<lpage>2</lpage>
<pub-id pub-id-type="pmid">19620573</pub-id>
</element-citation>
</ref>
<ref id="ref12"><label>12</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stewart</surname>
<given-names>CJ</given-names>
</name>
<name><surname>Chan</surname>
<given-names>T</given-names>
</name>
<name><surname>Platten</surname>
<given-names>M</given-names>
</name>
</person-group>
<article-title>Acquired lymphangiectasia (‘lymphangioma circumscriptum’) of the vulva: A report of eight cases</article-title>
<source>Pathology</source>
<year>2009</year>
<volume>41</volume>
<fpage>448</fpage>
<lpage>53</lpage>
<pub-id pub-id-type="pmid">19396719</pub-id>
</element-citation>
</ref>
<ref id="ref13"><label>13</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gnanaraj</surname>
<given-names>P</given-names>
</name>
<name><surname>Revathy</surname>
<given-names>V</given-names>
</name>
<name><surname>Venugopal</surname>
<given-names>V</given-names>
</name>
<name><surname>Tamilchelvan</surname>
<given-names>D</given-names>
</name>
<name><surname>Rajagopalan</surname>
<given-names>V</given-names>
</name>
</person-group>
<article-title>Secondary lymphangioma of vulva: A report of two cases</article-title>
<source>Indian J Dermatol</source>
<year>2012</year>
<volume>57</volume>
<fpage>149</fpage>
<lpage>51</lpage>
<pub-id pub-id-type="pmid">22615519</pub-id>
</element-citation>
</ref>
<ref id="ref14"><label>14</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tasdelen</surname>
<given-names>I</given-names>
</name>
<name><surname>Gokgoz</surname>
<given-names>S</given-names>
</name>
<name><surname>Paksoy</surname>
<given-names>E</given-names>
</name>
<name><surname>Yerci</surname>
<given-names>O</given-names>
</name>
<name><surname>Cetintas</surname>
<given-names>SK</given-names>
</name>
<name><surname>Demiray</surname>
<given-names>M</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Acquired lymphangiectasis after breast conservation treatment for breast cancer: Report of a case</article-title>
<source>Dermatol Online J</source>
<year>2004</year>
<volume>10</volume>
<fpage>9</fpage>
<pub-id pub-id-type="pmid">15347491</pub-id>
</element-citation>
</ref>
<ref id="ref15"><label>15</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kaya</surname>
<given-names>TI</given-names>
</name>
<name><surname>Kokturk</surname>
<given-names>A</given-names>
</name>
<name><surname>Polat</surname>
<given-names>A</given-names>
</name>
<name><surname>Tursen</surname>
<given-names>U</given-names>
</name>
<name><surname>Ikizoglu</surname>
<given-names>G</given-names>
</name>
</person-group>
<article-title>A case of cutaneous lymphangiectasis secondary to breast cancer treatment</article-title>
<source>Int J Dermatol</source>
<year>2001</year>
<volume>40</volume>
<fpage>760</fpage>
<lpage>1</lpage>
<pub-id pub-id-type="pmid">11903671</pub-id>
</element-citation>
</ref>
<ref id="ref16"><label>16</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jappe</surname>
<given-names>U</given-names>
</name>
<name><surname>Zimmermann</surname>
<given-names>T</given-names>
</name>
<name><surname>Kahle</surname>
<given-names>B</given-names>
</name>
<name><surname>Petzoldt</surname>
<given-names>D</given-names>
</name>
</person-group>
<article-title>Lymphangioma circumscriptum of the vulva following surgical and radiological therapy of cervical cancer</article-title>
<source>Sex Transm Dis</source>
<year>2002</year>
<volume>29</volume>
<fpage>533</fpage>
<lpage>5</lpage>
<pub-id pub-id-type="pmid">12218845</pub-id>
</element-citation>
</ref>
<ref id="ref17"><label>17</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mortimer</surname>
<given-names>PS</given-names>
</name>
<name><surname>Simmonds</surname>
<given-names>RH</given-names>
</name>
<name><surname>Rezvani</surname>
<given-names>M</given-names>
</name>
<name><surname>Robbins</surname>
<given-names>ME</given-names>
</name>
<name><surname>Ryan</surname>
<given-names>TJ</given-names>
</name>
<name><surname>Hopewell</surname>
<given-names>JW</given-names>
</name>
</person-group>
<article-title>Time-related changes in lymphatic clearance in pig skin after a single dose of 18 Gy of X rays</article-title>
<source>Br J Radiol</source>
<year>1991</year>
<volume>64</volume>
<fpage>1140</fpage>
<lpage>6</lpage>
<pub-id pub-id-type="pmid">1773273</pub-id>
</element-citation>
</ref>
<ref id="ref18"><label>18</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jackowski</surname>
<given-names>S</given-names>
</name>
<name><surname>Janusch</surname>
<given-names>M</given-names>
</name>
<name><surname>Fiedler</surname>
<given-names>E</given-names>
</name>
<name><surname>Marsch</surname>
<given-names>WC</given-names>
</name>
<name><surname>Ulbrich</surname>
<given-names>EJ</given-names>
</name>
<name><surname>Gaisbauer</surname>
<given-names>G</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Radiogenic lymphangiogenesis in the skin</article-title>
<source>Am J Pathol</source>
<year>2007</year>
<volume>171</volume>
<fpage>338</fpage>
<lpage>48</lpage>
<pub-id pub-id-type="pmid">17591978</pub-id>
</element-citation>
</ref>
<ref id="ref19"><label>19</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rodríguez-Bujaldón</surname>
<given-names>A</given-names>
</name>
<name><surname>Vázquez-Bayo</surname>
<given-names>MC</given-names>
</name>
<name><surname>Galán-Gutiérrez</surname>
<given-names>M</given-names>
</name>
<name><surname>Jiménez-Puya</surname>
<given-names>R</given-names>
</name>
<name><surname>Vélez</surname>
<given-names>García-Nieto A</given-names>
</name>
<name><surname>Moreno-Giménez</surname>
<given-names>JC</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Angiosarcoma in chronic lymphedema</article-title>
<source>Actas Dermosifiliogr</source>
<year>2006</year>
<volume>97</volume>
<fpage>525</fpage>
<lpage>8</lpage>
<pub-id pub-id-type="pmid">17067532</pub-id>
</element-citation>
</ref>
<ref id="ref20"><label>20</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Manner</surname>
<given-names>J</given-names>
</name>
<name><surname>Radlwimmer</surname>
<given-names>B</given-names>
</name>
<name><surname>Hohenberger</surname>
<given-names>P</given-names>
</name>
<name><surname>Mössinger</surname>
<given-names>K</given-names>
</name>
<name><surname>Küffer</surname>
<given-names>S</given-names>
</name>
<name><surname>Sauer</surname>
<given-names>C</given-names>
</name>
<etal></etal>
</person-group>
<article-title>MYC high level gene amplification is a distinctive feature of angiosarcomas after irradiation or chronic lymphedema</article-title>
<source>Am J Pathol</source>
<year>2010</year>
<volume>176</volume>
<fpage>34</fpage>
<lpage>9</lpage>
<pub-id pub-id-type="pmid">20008140</pub-id>
</element-citation>
</ref>
<ref id="ref21"><label>21</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bailin</surname>
<given-names>PL</given-names>
</name>
<name><surname>Kantor</surname>
<given-names>GR</given-names>
</name>
<name><surname>Wheeland</surname>
<given-names>RG</given-names>
</name>
</person-group>
<article-title>Carbon dioxide laser vaporization of lymphangioma circumscriptum</article-title>
<source>J Am Acad Dermatol</source>
<year>1986</year>
<volume>14</volume>
<fpage>257</fpage>
<lpage>62</lpage>
<pub-id pub-id-type="pmid">3081604</pub-id>
</element-citation>
</ref>
<ref id="ref22"><label>22</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Weingold</surname>
<given-names>DH</given-names>
</name>
<name><surname>White</surname>
<given-names>PF</given-names>
</name>
<name><surname>Burton</surname>
<given-names>CS</given-names>
</name>
</person-group>
<article-title>Treatment of lymphangioma circumscriptum with tunable dye laser</article-title>
<source>Cutis</source>
<year>1990</year>
<volume>45</volume>
<fpage>365</fpage>
<lpage>6</lpage>
<pub-id pub-id-type="pmid">2357907</pub-id>
</element-citation>
</ref>
<ref id="ref23"><label>23</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Khunger</surname>
<given-names>N</given-names>
</name>
</person-group>
<article-title>Combination technique of radiofrequency ablation with sclerotherapy in acquired lymphangiectasis of the vulva</article-title>
<source>J Cutan Aesthet Surg</source>
<year>2009</year>
<volume>2</volume>
<fpage>33</fpage>
<lpage>5</lpage>
<pub-id pub-id-type="pmid">20300370</pub-id>
</element-citation>
</ref>
</ref-list>
</back>
</pmc>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Pmc/Corpus

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002231 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 002231 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    LymphedemaV1
   |flux=    Pmc
   |étape=   Corpus
   |type=    RBID
   |clé=     PMC:4318044
   |texte=   Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer
}}

Pour générer des pages wiki

HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/RBID.i   -Sk "pubmed:25657438" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd   \
       | NlmPubMed2Wicri -a LymphedemaV1

This area was generated with Dilib version V0.6.31.
Data generation: Sat Nov 4 17:40:35 2017. Site generation: Tue Feb 13 16:42:16 2024

	Serveur d'exploration sur le lymphœdème
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Serveur d'exploration sur le lymphœdème

Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer

Acquired Lymphangiectasis Following Surgery and Radiotherapy of Breast Cancer

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki