This is a 40-year-old male patient from an urban area.
Patient had late primary lymphedema of the right lower limb of three years of evolution, assessed with lymphocen-tellography that showed absence of lymphatic drainage in that limb, computed tomography (CT) of abdomen, pelvis and thigh normal.
Recurrent skin infections of torpid course in that limb
She presented with a 1-month history of severe asthenia, anorexia, weight loss of 10 kg, with fever of up to 38°C axillary.
During the evolution cough was added with hemoptoic expectoration.
She had lesions on recent lymphedema.
The admission examination showed severe weight loss, fever and fever.
In the right lower limb, she presented lymphedema up to a thigh root with multiple nodular lesions of 5 mm in diameter, firm, glandular, some scaly, and other ulcerated lesions with a higher concentration of lesions in the pleilet region.
In the proximal thigh, the lesion was pedunculated and ulcerated.
Traumatic foot injury in healing pathways
Inguinal adenomegaly to the right, firm, 2 cm in diameter that did not form clusters.
Pleuropulmonary level showed the presence of scarce bicuspid subcrepitant sounds.
The rest of the physical examination was normal.
Laboratory tests revealed blood count, blood glucose, renal function and normal liver tests, ESR of 50 mm in the first hour, and C-reactive protein of 30 mg/dL.
Serology for HIV negative.
Bacilitates and Mantoux tests were negative.
The chest X-ray showed a left paracardiac nodular image.
A CT scan of the chest, abdomen and abdomen showed multiple bilateral pulmonary nodules, predominantly bifocal, poorly delimited pelvis and right inguinal and external iliac adenomegaly.
An incisional biopsy of the requested thigh lesion was performed, which was compatible with angiosarcoma. Immunohistochemistry was concordant (positivity for endothelial cell markers CD31 and CD34, the first with high sensitivity and specificity12).
The patient was evaluated by outpatient clinic and polychemotherapy plan was initiated.
The patient died 5 months after diagnosis.
