Abstract

Background: Stewart-Treves syndrome (STS) is a rare and deadly entity, involving the development of lymphangiosarcoma in chronically lymphedematous upper extremities following mastectomy. Case Description: A 57-year-old woman presented with a 3-month history of rapidly growing, painful skin lesions on her left distal forearm. Fourteen years previously, she had undergone a radical mastectomy with axillary lymph node dissection, adjuvant chemotherapy, and radiation therapy due to invasive left breast cancer. A surgical biopsy specimen obtained from the lesion revealed a high-grade angiosarcoma, indicative of STS. Magnetic resonance imaging and whole-body positron emission tomography revealed that the left distal forearm lesion extended to the condyle of the left humerus. The patient underwent a transhumeral amputation of the left upper limb, and an 8-month combination chemotherapy regimen was scheduled. She is still alive 22 months after the diagnosis of STS. Conclusion: This study may increase the clinician's awareness regarding the occurrence of STS in patients with chronic lymphedema, especially after mastectomy.

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