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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 58-year-old man&#44; with a seven-year history of chronic lymphedema in the left upper limb secondary to the obstruction of the vascular access for hemodialysis&#44; presented to the Emergency Department with an exacerbation of the edema accompanied by pain&#44; without any other clinical symptoms&#46; The arm was indurated&#44; warm&#44; and exhibited numerous infiltrated erythematous-violaceous papules and plaques &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1A</a>&#41;&#46; Analytically&#44; there was a slight elevation in acute phase reactants&#46; Following an ultrasound&#44; he was hospitalized for suspected bacterial cellulitis&#46; In the absence of response to antibiotic treatment&#44; he was evaluated by the dermatologist&#44; who performed a skin biopsy suspecting a cutaneous angiosarcoma&#46; The histological examination &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1B</a>&#44; hematoxylin-eosin&#44; &#215;20&#41; revealed an infiltrative malignant neoplasm&#44; positive for vimentin&#44; CD31 &#40;inset&#41;&#44; and CD34 &#40;inset&#41;&#44; and negative for cytokeratins&#44; confirming the diagnosis&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cutaneous angiosarcoma associated with chronic lymphedema is a well-documented entity in the context of breast cancer &#40;Stewart-Treves syndrome&#41;&#46; However&#44; its association with other etiologies causing lymphedema is less known&#44; which contributes to diagnostic delay&#46; The case we describe underscores this issue&#44; as the initial diagnostic approach was oriented towards more common complications in hemodialysis patients&#44; such as vascular or infectious diseases&#46; The role of the dermatologist is noteworthy&#44; who&#44; in the face of clinical suspicion&#44; should perform an early skin biopsy&#46;</p></span>"
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Images in Dermatology
A Rare Case of Cutaneous Angiosarcoma Secondary to Chronic Lymphedema in a Patient on Hemodialysis
Linfedema crónico en paciente hemodializado: etiología infrecuente del angiosarcoma cutáneo
A.M. Carballido Vázqueza,
Autor para correspondencia
anamcv@gmail.com

Corresponding author.
, C.M. Delgado Mucientesa, G. Martínez Garcíab, P. Manchado Lópeza
a Servicio de Dermatología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
b Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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