Angiosarcoma (Stewart-Treves Syndrome) Arising in a Paralytic Lymphedematous Limb Due to Cerebral Hemorrhage

Abstract

We report a case of a 73-year-old woman with angiosarcoma on the left upper extremity, which had been swollen for as long as four years because of lymphedema. For twelve years, she had been bed ridden with complete left hemiplegia due to cerebral hemorrhage. The left shoulder and elbow joints had been fixed in a contracting posture, which may be the cause of the lymphedema of the left upper extremity. Five months after amputation of the affected limb, the tumor recurred at the amputation edge and in the lung. She died of bilateral pneumohemothorax and disseminated intravascular coagulation syndrome. Many other conditions have been described that can induce lymphedema on which angiosarcoma could arise, such as congenital anomaly, obesity, and filariasis. However, no previous report has mentioned cerebro-vascular disease as a cause of angiosarcoma. It must be noted that lymphedema of the contracted limb due to cerebro-vascular disease may cause Stewart-Treves syndrome.