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Reminder of important clinical lesson
CASE REPORT
Cutaneous lymphangitis carcinomatosa made cervicofacial oedema intractable in a patient with superior vena cava syndrome
  1. Eriko Kashihara1,
  2. Osamu Kanai2,
  3. Misato Okamura2,
  4. Tadashi Mio2
  1. 1 Division of General Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
  2. 2 Division of Respiratory Medicine, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
  1. Correspondence to Dr Osamu Kanai, geminus75{at}gmail.com

Summary

Cutaneous lymphangitis carcinomatosa (CLC) is a rare form of cutaneous metastasis that causes lymphoedema and various eruptions. We report a case of lung cancer with CLC that caused both superior vena cava (SVC) stenosis and cervicofacial oedema, suggestive of SVC syndrome. A 64-year-old woman with lung adenocarcinoma presented with cervicofacial oedema and erythema, followed by severe dyspnoea 2 months after four cycles of carboplatin, pemetrexed and bevacizumab triplet therapy. Although chest CT indicated SVC stenosis, cervicofacial oedema remained despite treating the SVC stenosis via balloon dilation. A skin biopsy of the erythematic sample confirmed CLC as the cause of the patient’s symptoms. CLC should be considered as a differential diagnosis of cervicofacial oedema in addition to SVC syndrome, especially when it is observed in combination with skin erythema and induration. Moreover, a skin biopsy should be performed promptly for accurate diagnosis of CLC and to decide on appropriate treatment.

  • dermatology
  • lung cancer (oncology)
  • skin cancer
  • cancer - see oncology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bcr-2018-224206

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    Footnotes

    • Contributors EK wrote and revised the draft, and made the conception of this work. OK revised the draft and advised for the content of discussion part. MO was involved in the treatment of the patient and got a consent form. TM advised for the content of case presentation, especially for the images which should be used for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Patient consent Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.