[Lymphangiosarcoma with postmastectomy edema of the arm]

A case of a lymphangiosarcoma (LAS) in a chronic postmastectomy lymphedematous arm in a 67 y.o; women is reported. The LAS was found 8 years after a radical left mastectomy for cancer and 7 years after the development of a lymphedema in the left arm. Because of a rapid spread of the disease no surgical treatment was done. The patient died 14 months after the diagnosis. Lymphangiosarcoma is a rare neoplasia that usually arise in chronic lymphedematous limbs mostly in post-mastectomy lymphedema of the arms. Chronic lymphedema is an important neoplastic stimuli decreasing the local immunity, as well leading to lymphoproliferative and degenerative changes of collagenous and fat tissues. Usually it appears as a multicentric lesion like bluish nodules, sclerotic plaques, bullous lesions. Lungs, pleura and thoracic wall are the most common sites of metastatic disease. The DD should be done with Kaposi sarcoma, hemangioma, hemangiopericytoma. The prognosis is always poor and after treatment the mean survival time is 18 months. The best treatment that gives a temporary result is the ablative surgery. Therefore because of unsuccessful therapeutic procedures a particular care should be paid to avoid postmastectomy lymphedema leaving, when possible, a reasonable lymphatic drainage of the arm.