Treatment of Refractory Lower Extremity Ulcer Associated with Sneddon's Syndrome

277 irregular or sinusoidal vessel pattern. High-grade, poorly differentiated lesions can comprise undifferentiated cells, so they are difficult to differentiate from other malignancies. These tumors can be confirmed via immunohistochemistry and are usually positive for factor-VIII-related antigen, vimentin, CD34, and CD31. Wide excision is the only known curative treatment option for the localized disease, and there is no known effective therapy for the metastatic disease [4]. Thus, only early diagnosis and prompt radical excision with or without adjuvant radiotherapy can promote survival. The diagnosis can be delayed, however, because it may show only erythema, swelling, and a papule-like skin lesion initially, and ulceration, hemorrhage, and mass fungation later [3]. Thus, if there is pain, sudden enlargement, or purple-red nodules on the skin of the involved extremity, recognition of their significance and their prompt evaluation by a surgeon are very important. In conclusion, the authors experienced a case of Stewart-Treves syndrome in the lower leg, which was misdiagnosed initially and therefore, the treatment of which was delayed. It was reported herein because an atypical skin lesion in a chronically edematous limb can be malignant even if it looks benign, and a high level of suspicion and early management of the lesion are very important in improving the potential for patient survival.