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Vol. 55. Issue 4.
Pages 320-324 (October - December 2021)
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Vol. 55. Issue 4.
Pages 320-324 (October - December 2021)
CASO CLÍNICO
Síndrome axillary web tras cirugía de cáncer de mama. Variante rara con nódulos subcutáneos
Axillary web syndrome following breast cancer surgery. Rare variant with subcutaneous nodules
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A.B. Puentes Gutiérreza,
Corresponding author
anapuentes@hotmail.com

Autor para correspondencia.
, M. García Basconesa, R. Puentes Gutiérrezb, M. Rubio Melladoa, C. Esteban Estebanc, M. García Ávilad
a Servicio de Rehabilitación, Complejo Hospitalario de Toledo, Toledo, España
b Atención Primaria, Valladolid, España
c Servicio de Oncología, Complejo Hospitalario de Toledo, Toledo, España
d Servicio de Cirugía General, Complejo Hospitalario de Toledo, Toledo, España
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Resumen

Se presenta el caso de una mujer de 49 años, tratada e intervenida por cáncer de mama, quien, a las 3semanas de presentar síndrome de axillary web (SAW), desarrolló nódulos subcutáneos, blandos e indoloros a lo largo de su recorrido y cerca de la flexura del codo. Las pruebas complementarias (ecografía Doppler y de partes blandas) descartaron etiología dérmica/subcutánea o neoplásica, y se evidenció trombosis venosa cefálica y cubital. Se pautó tratamiento con anticoagulante y a las 3-4 semanas el SAW mejoró y los nódulos desaparecieron. Con la clínica, evolución y las pruebas complementarias realizadas, junto con la evidencia científica publicada, se diagnosticó de SAW con nódulos subcutáneos.

El SAW es una complicación posquirúrgica precoz del cáncer de mama conocida entre los profesionales y cuyo diagnóstico es clínico. La asociación del SAW con nódulos subcutáneos es una de las variantes poco frecuente, en las que es preciso ampliar el estudio. Se cree que los nódulos, al igual que el SAW, son debidos a procesos trombóticos linfovenosos.

Palabras clave:
Síndrome de axillary web
Nódulos
Cáncer de mama
Abstract

We describe the case of a 49-year-old woman who, after surgical treatment of breast cancer, developed axillary web syndrome (AWS) followed, 3 weeks later, by the appearance of soft and painless subcutaneous nodules along the cords and close to the flexure of the elbow. After tests (soft tissue and Doppler ultrasound), a dermal/subcutaneous or neoplastic cause was ruled out, although a cephalic and ulnar venous thrombosis was revealed. Anticoagulant medication was prescribed, with disappearance of the nodules 3-4 weeks later and improvement of AWS. The symptoms, clinical course, diagnostic tests, as well as the published evidence, helped to establish a diagnosis of AWS with subcutaneous nodules.

AWS is an early complication after axillary surgery, which is well known among breast cancer professionals and whose diagnosis is based on clinical presentation. Its association with subcutaneous nodules is one of its rare variants and requires compulsory complementary studies to exclude other causes. Like AWS, nodules are believed to be due to lymphatic vessel thrombosis.

Keywords:
Axillary web syndrome
Nodules
Breast cancer

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