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Stewart-Treves Syndrome on the Lower Extremity Associated to Idiopathic Chronic Lymphedema Visualized on FDG PET/CT

Brittain, Jane Maestri MD*; Nymark, Tine MD, PhD†‡; Hildebrandt, Malene Grubbe MD, PhD§; Hovgaard, Dorrit MD; Andersen, Kim Francis MD*

doi: 10.1097/RLU.0000000000001856
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Angiosarcomas are highly malignant and rare tumors of vascular or lymphatic endothelial cell origin with a poor prognosis. Lymphangiosarcoma associated with chronic lymphedema is known as Stewart-Treves syndrome. Stewart-Treves syndrome is primarily described in patients with lymphedema of an upper extremity occurring after breast cancer surgery including radical axillary lymph node dissection and subsequent radiotherapy. It is rarely described in the presence of idiopathic chronic lymphedema of the lower extremities. We present a case of lymphangiosarcoma visualized on 18F-FDG PET/CT, where Stewart-Treves syndrome is secondary to probably a combination of idiopathic chronic lymphedema of the lower extremities and systemic immunosuppressive treatment.

From the *Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen; †Department of Orthopedic Surgery, Odense University Hospital, University of Southern Denmark, Odense; ‡Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Copenhagen; and §Department of Nuclear Medicine, Odense University Hospital, University of Southern Denmark, Odense, Denmark.

Received for publication June 19, 2017; revision accepted September 8, 2017.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Jane Maestri Brittain, MD, Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. E-mail: jmbrittain@dadlnet.dk.

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