3 years ago

Síndrome de axillary web, una etiopatogenia incierta

B. Mur Molina, B. Alonso Álvarez

Publication date: Available online 17 July 2018

Source: Rehabilitación

Author(s): B. Mur Molina, B. Alonso Álvarez

Resumen

El síndrome de axillary web (SAW) se caracteriza por la aparición de «cordones» elevados debajo de la piel de la axila y el brazo medial en el período postoperatorio inmediato de una disección ganglionar axilar o biopsia de ganglio centinela. Los cordones suelen ir acompañados de limitación de la movilidad del hombro, principalmente la abducción.

Su patogénesis (etiología linfática o venosa) a día de hoy es incierta, siendo significativa dada la alta prevalencia de este síndrome.

Presentamos el caso de una paciente de 51 años con clínica de SAW a la cual le solicitamos una linfogammagrafía al diagnóstico y otra a los meses. Ambas informaron sobre la retención del trazador y de imágenes nodulares irregulares en el brazo, mejorando los resultados con la sintomatología del paciente.

Con este caso clínico apoyamos el origen linfático de este síndrome, sin poder descartar una afectación venosa concomitante.

Abstract

Axillary web syndrome (AWS) is characterized by the development of elevated «cords» under the skin of the axilla and medial arm in the immediate postoperative period after axillary lymph node dissection or sentinel lymph node biopsy. There is usually decreased upper-extremity range of motion, mainly abduction.

The pathogenesis (lymphatic or venous aetiology) is currently unclear, but is important, given the high prevalence of this syndrome.

We present the case of a 51-year-old woman with symptoms of AWS, who underwent lymphoscintigraphy at diagnosis and again 2 months later. Both investigations showed tracer retention and irregular nodules in the arm. The results improved with the patient's symptoms.

This case report supports a lymphatic aetiology of this syndrome, without ruling out concomitant venous involvement.

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