Lymphangiosarcoma in late‐onset hereditary lymphedema: Case report and nosological implications

Abstract

Hereditary lymphedemas that are not associated with other malformations usually affect the lower limbs and are inherited in an autosomal dominant fashion. These non‐syndromic hereditary lymphedemas are categorized by their age of onset, being either congenital (Milroy disease) or having an onset in childhood or around puberty (Meige disease). We describe a family in which three individuals in three generations had unusually late onset of lym‐phedema in their mid‐twenties or thirties. The proband additionally developed a very rare lymphangiosarcoma. This tumor, usually associated with post‐mastectomy lym‐phedema, has not been described in late‐onset hereditary lymphedema. Because of an unusually high incidence of multiple primary tumors in association with lymphangiosarcoma in the literature (approximately 10%) and the proband's own familial cancer background, we speculate that an inherited predisposition to malignancy may underlie the development of lymphedema‐associated lymphangiosarcoma.