Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a rapidly enlarging, violaceous to erythematous cutaneous lesion. History of prior radiation therapy, chronic lymphedema (Stewart-Treves syndrome), or sun exposure noted. Patient reports increasing size, spontaneous bleeding, or ulceration. No systemic symptoms of metastatic disease reported.
Clinical Examination Findings
Physical examination reveals a poorly defined, infiltrative, purpuric plaque or nodule. Lesion demonstrates friability, easy bleeding upon palpation, and potential satellite nodules. Surrounding skin shows signs of chronic lymphedema or radiation-induced changes. Regional lymphadenopathy assessed; skin temperature and consistency documented.
Treatment Protocol
Surgical management involves wide local excision with confirmed negative margins (R0 resection). Given the high risk of local recurrence, adjuvant radiotherapy is often indicated. Sentinel lymph node biopsy or regional lymph node dissection performed if clinically indicated. Multidisciplinary tumor board consultation required for systemic therapy planning.