A Case of Stewart Treves Syndrome Successfully Treated with Pazopanib during Hemodialysis

Abstract

A 75-year-old woman had received hemodialysis for 24 years. She underwent total mastectomy, bilateral axillary lymph node dissection, and radiotherapy for bilateral breast cancer 13 years ago. Purpuric macules appeared on her left upper arm 2 years ago and gradually developed. On the first visit to our hospital, multiple hemorrhagic nodules were observed on the whole left upper arm with lymphedema. As histological findings of the nodule revealed angiosarcoma, we diagnosed her with Stewart Treves syndrome with lymphedema that appeared on the upper arm after surgery for breast cancer. Left axillary lymph node metastasis, but no distant metastasis was observed at that time. Although radiation therapy diminished tumor sizes, local recurrence occurred, and lung metastasis was also observed 2 and a half months after the treatment. Therefore, the administration of pazopanib was initiated. Recurrent skin lesions and lung metastasis disappeared after oral administration of pazopanib (400 mg/day for 3 months), but local recurrence appeared again 11 months after the pazopanib treatment. Pazopanib has been administered continuously because of the recurrent skin lesions that have developed slowly. Based on these findings, we consider that pazopanib may be one of the effective therapies for angiosarcoma in patients receiving hemodialysis.[Skin Cancer (Japan) 2018 ; 33 : 231-237]