An "anaplastic" Kaposi's sarcoma mimicking a Stewart-Treves syndrome. A case report and a review of literature

Am J Dermatopathol. 2008 Jun;30(3):265-8. doi: 10.1097/DAD.0b013e318169fd5f.

Abstract

Cutaneous angiosarcoma (AGS) developing in a lymphedematous arm, after lymphadenectomy in the context of breast cancer, is the definition of the classical Stewart-Treves syndrome. Like AGS, many tumors such as Kaposi's sarcoma (KS) could develop in chronic lymphedema. We describe the case of a 50-year-old woman who presented with several nodules on the left lymphedematous arm evocative of a Stewart-Treves syndrome, 2 years after a left mastectomy and a homolateral lymphadenectomy. The histological examination revealed an atypical vascular proliferation suggesting AGS, but endothelial atypical cells nuclei were strongly stained by herpes human virus 8 antibody. The final diagnosis was an "anaplastic" KS mimicking a Stewart-Treves syndrome. The total regression of the lesion was obtained by elastic contention and intradermic liposomal doxorubicin. "Anaplastic" KS is a rare histological form of nodular KS, which mimics a cutaneous AGS but classically expresses herpes human virus 8. It is essential to know about this entity, particularly in a lymphedematous arm, to avoid aggressive treatment such as amputation.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor / analysis
  • DNA, Neoplasm / analysis
  • Diagnosis, Differential
  • Female
  • Hemangiosarcoma / diagnosis*
  • Herpesvirus 8, Human / isolation & purification
  • Humans
  • Lymphangiosarcoma / diagnosis*
  • Lymphedema / etiology
  • Lymphedema / pathology*
  • Middle Aged
  • Sarcoma, Kaposi / chemistry
  • Sarcoma, Kaposi / pathology*
  • Sarcoma, Kaposi / virology
  • Skin Neoplasms / chemistry
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / virology
  • Syndrome
  • Viral Proteins / metabolism

Substances

  • Biomarkers, Tumor
  • DNA, Neoplasm
  • Viral Proteins
  • assembly protein, Human herpesvirus 8