Here we report on four cases of angiosarcoma in a lower leg ; the patients were admitted to Kyushu University Hospital between 2008 and 2012. One of the cases was a lymph node metastasis from a lower leg 15 years before the admission. All four cases were female, and their ages when they were first diagnosed as angiosarcoma were 39, 49, 67 and 76 years, respectively. Three of the four cases had a history of chronic lymphedema, so we diagnosed the condition as Stewart-Treves syndrome. Multimodal treatment using a combination of surgery, chemotherapy and radiotherapy was performed. Compared with the previously reported cases of angiosarcoma in the lower leg and with those in the head and neck region, relatively younger ages and female dominance were observed. Most cases of angiosarcoma in a lower leg were associated with chronic lymphedema, which is referred to as Stewart-Treves syndrome. We should be aware of this tumor when managing patients suffering from chronic lymphedema.
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