Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis.
Shelley Ji Eun HwangBenjamin Y KongShaun ChouDeepal WakadeMatteo S CarlinoPablo Fernandez-PenasPublished in: Case reports in medicine (2017)
There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event.
Keyphrases
- lymph node metastasis
- lymph node
- early stage
- sentinel lymph node
- case report
- liver failure
- squamous cell carcinoma
- ultrasound guided
- locally advanced
- papillary thyroid
- computed tomography
- neoadjuvant chemotherapy
- respiratory failure
- drug induced
- radiation therapy
- aortic dissection
- radiation induced
- coronary artery disease
- stem cells
- magnetic resonance imaging
- skin cancer
- magnetic resonance
- dual energy
- image quality
- rectal cancer
- robot assisted
- minimally invasive
- combination therapy
- gestational age
- mesenchymal stem cells
- cell therapy
- bone marrow
- acute respiratory distress syndrome