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一名患有Klippel-Trenaunay综合征患者的放射性血管肉瘤:病例报告

Radiation-Induced Angiosarcoma in a Patient With Klippel-Trenaunay Syndrome: A Case Report.

作者信息

Nehila Timothy, Bair Carson, Alford Nicholas, Dayicioglu Deniz

机构信息

USF Health Morsani College of Medicine, University of South Florida, Tampa, Florida.

Department of Plastic Surgery, Morsani College of Medicine, University of South Florida, Tampa, Florida.

出版信息

Eplasty. 2024 Aug 16;24:e46. eCollection 2024.

Abstract

BACKGROUND

Klippel-Trenaunay syndrome (KTS) is a rare vascular disorder that typically presents in the lower limb with unilateral port-wine discoloration of the skin due to capillary malformations, varicose veins, and soft tissue and bone overgrowth. Radiation-induced angiosarcoma (RIAS) is a rare vascular malignancy that develops as a long-term complication secondary to radiation therapy. While there is no well-established direct relationship between KTS and development of angiosarcoma, there is literature that suggests a logical association between the 2 disorders. The present case report highlights the importance of further research into a potential connection between KTS and RIAS.

METHODS

A 51-year-old female with a history of KTS was referred to the plastic surgery clinic for delayed breast reconstruction following RIAS of the left breast. It was decided that a 2-stage left latissimus dorsi musculocutaneous flap reconstruction with silicone implant would best achieve her goal of symmetry.

RESULTS

The patient reported here had an unremarkable postoperative course. Of note, this patient experienced severe body dysmorphia after her mastectomy and RIAS excision due to the absence of her left breast juxtaposed with her prior large right breast augmentation. The choice of 2-stage combined autologous/implant reconstruction likely contributed to her satisfactory cosmetic outcome.

CONCLUSIONS

While RIAS and KTS are distinct conditions, a link may exist between the two. More research is needed to investigate this possible relationship. Aggressive treatment of RIAS is crucial for patient recovery, and a 2-stage combined autologous/implant reconstruction is an optimal choice for post-RIAS reconstruction, especially in patients hoping to achieve a large breast size.

摘要

背景

克-特综合征(KTS)是一种罕见的血管疾病,通常表现为下肢单侧皮肤葡萄酒色斑,这是由毛细血管畸形、静脉曲张以及软组织和骨骼过度生长所致。放射诱导性血管肉瘤(RIAS)是一种罕见的血管恶性肿瘤,作为放射治疗的长期并发症而发生。虽然KTS与血管肉瘤的发生之间没有明确确立的直接关系,但有文献表明这两种疾病之间存在合理的关联。本病例报告强调了进一步研究KTS与RIAS之间潜在联系的重要性。

方法

一名有KTS病史的51岁女性因左乳发生RIAS后延迟乳房重建被转诊至整形外科诊所。决定采用两阶段的带蒂背阔肌肌皮瓣联合硅胶植入物重建,这将最能实现她的对称目标。

结果

本文报告的患者术后过程顺利。值得注意的是,由于左乳缺失,与之前进行过的右侧大乳房隆乳术相比,该患者在乳房切除和RIAS切除术后出现了严重的身体变形障碍。两阶段联合自体/植入物重建的选择可能促成了她令人满意的美容效果。

结论

虽然RIAS和KTS是不同的病症,但两者之间可能存在联系。需要更多研究来调查这种可能的关系。积极治疗RIAS对患者康复至关重要,两阶段联合自体/植入物重建是RIAS术后重建的最佳选择,尤其是对于希望增大乳房尺寸的患者。

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本文引用的文献

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Klippel-Trenaunay Syndrome.克-特综合征
Tech Vasc Interv Radiol. 2019 Dec;22(4):100634. doi: 10.1016/j.tvir.2019.100634. Epub 2019 Sep 23.
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Radiation-induced angiosarcoma of the breast: A review.放射性诱导性乳腺血管肉瘤:综述。
Breast J. 2020 Mar;26(3):458-463. doi: 10.1111/tbj.13504. Epub 2019 Aug 25.
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Cancer Risk in Klippel-Trenaunay Syndrome.克-特综合征中的癌症风险
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