Breast and endocrine surgery: lymphangiosarcoma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Breast and endocrine surgery: lymphangiosarcoma

Sample item

Ten years after a radical mastectomy with axillary clearance, a woman with a chronically swollen arm develops violaceous nodules on the skin of the forearm that coalesce and ulcerate. Biopsy shows malignant vascular channels. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Stewart-Treves syndrome

Stewart-Treves syndrome is an angiosarcoma (lymphangiosarcoma) arising in chronically lymphoedematous limbs, classically after mastectomy. It has a poor prognosis, and treatment is wide excision or amputation, though recurrence is common.

Option by option

  • A. Kaposi sarcoma

    Kaposi sarcoma is linked to HHV-8 and immunosuppression, not to chronic lymphoedema after mastectomy.

  • B. Cutaneous lymphoma

    Cutaneous lymphoma would show lymphoid infiltrates on histology.

  • C. Metastatic breast carcinoma

    Metastatic carcinoma would show epithelial cells rather than vascular channels.

  • D. Stewart-Treves syndrome (correct)

    Correct. Angiosarcoma in a chronically lymphoedematous arm is Stewart-Treves syndrome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Stewart-Treves syndrome. Stewart-Treves syndrome is an angiosarcoma (lymphangiosarcoma) arising in chronically lymphoedematous limbs, classically after mastectomy.

Why is "Kaposi sarcoma" not the answer?

Kaposi sarcoma is linked to HHV-8 and immunosuppression, not to chronic lymphoedema after mastectomy.

Why is "Cutaneous lymphoma" not the answer?

Cutaneous lymphoma would show lymphoid infiltrates on histology.

Why is "Metastatic breast carcinoma" not the answer?

Metastatic carcinoma would show epithelial cells rather than vascular channels.

What concept does this question test?

It tests Breast and endocrine surgery: lymphangiosarcoma in General Surgery. It has a poor prognosis, and treatment is wide excision or amputation, though recurrence is common.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Breast and endocrine surgery: lymphangiosarcoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.