Two Cases of Lower-Limb Stewart–Treves Syndrome Potentially Associated with Chronic Edema

Abstract

Stewart–Treves syndrome (STS) is an extremely rare form of angiosarcoma that occurs as a complication of chronic lymphoedema. It was previously considered a disease that occurred following post-operative upper limb lymphedema associated with breast cancer. Recently, the advent of minimally invasive surgical methods has reduced the number of reported cases of STS in the upper limbs. On the other hand, there has been an increase in reports of STS in the lower limbs, with most cases arising as a complication of lower limb lymphedema following radical hysterectomy for uterine cancer. In this report, we present two cases of STS. The first case developed chronic leg edema following coronary artery bypass grafting, which was localized to the area of great saphenous vein harvesting. The second case occurred after repair of an inguinal hernia through the anterior approach. These cases suggest that chronic postoperative edema of the abdomen or lower extremities is a predisposing factor for STS. In cases of chronic lower extremity edema accompanied by purpura, STS should be included in the differential diagnosis.