Question

The most common site of lymphangiosarcoma is

• A. Liver
• B. Spleen
• C. Post-mastectomy oedema of the arm
• D. Retroperitoneum

Hint:

Think of the eponymous syndrome that follows years of arm swelling after breast surgery.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
This question asks about the classic clinical setting in which lymphangiosarcoma, a rare malignant tumour of lymphatic vessels, most commonly arises.

Step 2: Key Concept or Approach:
Lymphangiosarcoma almost always develops in a limb that has long-standing lymphoedema. The best-known example is chronic lymphoedema of the arm following radical mastectomy with axillary lymph node clearance for breast cancer, a clinical picture known as Stewart-Treves syndrome. Chronic lymphatic stasis, whatever its cause, is thought to create the conditions for malignant transformation of lymphatic endothelium.

Step 3: Working Through the Options:
The liver is the classic site for angiosarcoma linked to vinyl chloride or arsenic exposure, not lymphangiosarcoma. The spleen can rarely harbour vascular tumours, but it is not the characteristic site taught for this tumour. The retroperitoneum can be a site for various soft-tissue sarcomas, but again it is not the classic association. Post-mastectomy lymphoedema of the arm is the textbook setting in which lymphangiosarcoma most commonly arises, appearing years after mastectomy as a bruise-like or nodular lesion in the chronically swollen limb.

Step 4: Conclusion:
Post-mastectomy oedema of the arm is correct, since chronic lymphoedema following mastectomy is the classic setting for lymphangiosarcoma, known eponymously as Stewart-Treves syndrome.