Lymphangiosarcoma of mons pubis following radiotherapy for carcinoma cervix.

Abstract

Common post-irradiation vascular tumors are post-radiation angiosarcoma, atypical vascular lesions, lymphangiomatosis, and lymphangiosarcoma. While atypical vascular lesions and lymphangiomatosis behave in a benign fashion, post-radiation angiosarcoma and lymphangiosarcoma have a significantly high mortality. Post-radiation angiosarcoma/lymphangiosarcoma usually occurs after an interval of 5–11 years following irradiation for carcinoma of the breast, ovary, uterus, and cervix [1]. This condition is often difficult to diagnose due to its rarity, relatively bland appearance, difficulty in differentiation from radiation-induced changes in the skin, and close mimickers like atypical vascular proliferation and lymphangiomatosis. Meticulous morphological assessment remains the cornerstone to differentiate between angiosarcoma and lymphangiosarcoma from their benign mimikers like atypical vascular proliferation and lymphangiomatosis. It is difficult to differentiate malignant vascular tumors of blood vessel and lymph vessel origin solely on morphological grounds. However, recently, D2-40, a new selective monoclonal marker of lymphatic endothelium, has gained importance in differentiating angiosarcoma from lymphangiosarcoma [2]. Lymphangiosarcoma of the mons pubis following radiotherapy is an extremely uncommon entity. Recently, we have seen such a case where the patient had received radiotherapy for carcinoma cervix 15 years prior to the present illness. To the best of our knowledge, this is the first case of post-irradiation lymphangiosarcoma of the mons pubis in the English literature, and hence it is being reported for its rarity.