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K. Arnaoutakis



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    P3.24 - Poster Session 3 - Supportive Care (ID 160)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P3.24-052 - Myxoid mesenchymal neoplasm presenting as massive arm and chest wall edema with pleural effusion (ID 3401)

      09:30 - 09:30  |  Author(s): K. Arnaoutakis

      • Abstract

      Background
      not applicable

      Methods
      Figure 1 This patient is a 50-year-old Hispanic woman who had been diagnosed with idiopathic edema of the right upper extremity and chest wall which progressed gradually over the last 8 years. Over the last year and-a-half, she has developed dyspnea on exertion with occasional cough. She has occasional right chest wall discomfort, but no abdominal pain. She has arm and back pain from the massive swelling. She has no GI complaints with the exception of nausea after meals. She has no lower extremity edema, no fever, chills or sweats. During our evaluation she was found to have massive right-sided pleural effusion.

      Results
      Figure 1 Biopsies of the pleura , soft tissues, and skin showed a myxoid mesenchymal neoplasm. Brain MRI showed no intracranial or meningeal masses. Her pleural fluid was most consistent with exudate. Cultures and cytology was negative. Glucose in the pleural fluid was not decreased. Triglycerides in the pleural fluid were 21 mg/dL.

      Conclusion
      This is an unsual case of a soft tissue sarcoma with significant swelling of the entire arm and ipsilateral chest with metastasis to the pleura. She had previously been diagnosed with idiopathic lymphededma and treated for that for years. The swelling was likely not due to lymphatic obstruction but rather due to slow progressive growth of the myxoid mesenchymal neoplasm. Earlier definitive diagnosis could have led to potential surgical resection, but with the massive involvement of her entire right arm, and ispilateral hemithorax, supportive care and systemic chemotherapy are the only treatment options.