Tomita K, Yokogawa A, Oda Y, Terahata S
Department of Orthopaedic Surgery, Kanazawa University School of Medicine, Japan.
J Surg Oncol. 1988 Aug;38(4):275-82. doi: 10.1002/jso.2930380415.
Two cases of lymphangiosarcoma arising in a chronic lymphedematous extremity following mastectomy (Stewart-Treves syndrome) were reported with not only standard histology, but also special study on the ultrastructure and immunohistology. These cancers developed as a result of chronic lymphedema of the involved limb following mastectomy 15 and 16 years ago, respectively, for breast carcinoma. Immunohistologic and electron microscopic examinations proved that this tumor originates in the vascular endotheliocytes, even though they are clinically chronic lesions apparently derived from the lymphatic vessels. This sarcoma develops multicentrically in an edematous arm and spreads out rapidly, so prognosis is quite discouraging in those patients. They need to be radically surgically treated without hesitation; hence, amputation, not limb-saving surgery, should be indicated.
报道了两例乳房切除术后慢性肢体淋巴水肿（斯图尔特-特里夫斯综合征）继发的淋巴管肉瘤病例，不仅进行了标准组织学检查，还对超微结构和免疫组织学进行了专门研究。这些癌症分别是在15年前和16年前因乳腺癌行乳房切除术后，受累肢体发生慢性淋巴水肿而发展而来的。免疫组织学和电子显微镜检查证明，这种肿瘤起源于血管内皮细胞，尽管在临床上它们显然是源自淋巴管的慢性病变。这种肉瘤在水肿的手臂上多中心发生并迅速扩散，因此这些患者的预后相当不乐观。需要毫不犹豫地对其进行根治性手术治疗；因此，应选择截肢，而非保肢手术。
