Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis
Identifieur interne : 002137 ( Pmc/Curation ); précédent : 002136; suivant : 002138Acute 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.
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DOI: 10.1155/2017/5462929
PubMed: 28182109
PubMed Central: 5274679
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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></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></affiliation></author><author><name sortKey="Kong, Benjamin Y" sort="Kong, Benjamin Y" uniqKey="Kong B" first="Benjamin Y." last="Kong">Benjamin Y. 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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></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></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></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></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></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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<front><journal-meta><journal-id journal-id-type="nlm-ta">Case Rep Med</journal-id><journal-id journal-id-type="iso-abbrev">Case Rep Med</journal-id><journal-id journal-id-type="publisher-id">CRIM</journal-id><journal-title-group><journal-title>Case Reports in Medicine</journal-title></journal-title-group><issn pub-type="ppub">1687-9627</issn><issn pub-type="epub">1687-9635</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28182109</article-id><article-id pub-id-type="pmc">5274679</article-id><article-id pub-id-type="doi">10.1155/2017/5462929</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-4387-486X</contrib-id><name><surname>Hwang</surname><given-names>Shelley J. E.</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kong</surname><given-names>Benjamin Y.</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Chou</surname><given-names>Shaun</given-names></name><xref ref-type="aff" rid="I4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Wakade</surname><given-names>Deepal</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Carlino</surname><given-names>Matteo S.</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref><xref ref-type="aff" rid="I3"><sup>3</sup></xref><xref ref-type="aff" rid="I5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Fernandez-Penas</surname><given-names>Pablo</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Dermatology, Westmead Hospital, Westmead, NSW, Australia</aff><aff id="I2"><sup>2</sup>Sydney Medical School, The University of Sydney, Sydney, NSW, Australia</aff><aff id="I3"><sup>3</sup>Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia</aff><aff id="I4"><sup>4</sup>Department of Tissue Pathology, Westmead Hospital, Westmead, NSW, Australia</aff><aff id="I5"><sup>5</sup>Melanoma Institute Australia, Sydney, NSW, Australia</aff><author-notes><corresp id="cor1">*Shelley J. E. Hwang: <email>shelley.hwang@hotmail.com</email></corresp><fn fn-type="other"><p>Academic Editor: Giuseppe Micali</p></fn></author-notes><pub-date pub-type="ppub"><year>2017</year></pub-date><pub-date pub-type="epub"><day>15</day><month>1</month><year>2017</year></pub-date><volume>2017</volume><elocation-id>5462929</elocation-id><history><date date-type="received"><day>19</day><month>8</month><year>2016</year></date><date date-type="rev-recd"><day>2</day><month>12</month><year>2016</year></date><date date-type="accepted"><day>20</day><month>12</month><year>2016</year></date></history><permissions><copyright-statement>Copyright © 2017 Shelley J. E. Hwang et al.</copyright-statement><copyright-year>2017</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><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></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>(a) Erythematous cutaneous reactions on left upper back spreading to lower back and to (b) axilla and flank.</p></caption><graphic xlink:href="CRIM2017-5462929.001"></graphic></fig></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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