Acquired lymphangiectasis following surgery and radiotherapy of breast cancer

Abstract

Acquired lymphangiectasia (AL) is a significant and rare complication of surgery and radiotherapy. We report lymphangiectasia in a 40-year-old woman who had undergone radical mastectomy and radiotherapy. After 4 years of combined therapy, she developed multiple vesicles and bullae. Skin biopsy confirmed the diagnosis of lymphangiectasia. The case is unique as it is not associated with lymphedema, which is a usual accompaniment of lymphangiectasia following surgery and radiotherapy. AL is usually asymptomatic, but trauma may cause recurrent cellulitis. Treatment modalities include electrodessication, surgical excision, sclerotherapy and carbon dioxide laser ablation.

Keywords: Acquired lymphagiectasia; lymphedema; radiation; surgery.

Figure 1

Multiple grouped vesicles and bullae on the right mammary region and lateral wall of chest and right hypochondrium

Figure 2

Purple and translucent vesicles and hypertrophic pedunculated bullae

Figure 3

Histopathology skin showing numerous dilated lymphatics in the superficial and papillary dermis (H and E, ×10)

Figure 4

Histopathology skin showing dilated lymphatics in the superficial and papillary dermis lined by flattened endothelial cells with mild hyperkeratosis (H and E, ×40)