Issue: 2016 > February > photo quiz

An 88-year-old woman with an ulcerous tumour on the leg

N. Atiq, R.E. Kibbelaar, F. de Vries, M. Hoogendoorn
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An 88-year-old woman was referred because of rapidly growing swellings on both legs including one large ulcerous tumour on the right leg. Two weeks prior to admission, the swellings and ulcer were growing rapidly, resulting in oedematous and painful legs. The patient’s medical history was uneventful. She only used hydrochlorothiazide for hypertension.
Physical examination evidenced multiple red to bluish tumours on both legs with one large ulcerated tumour with a diameter of 6 cm medially on the right lower leg (figure 1a and 1b). No additional abnormalities were found except one enlarged inguinal node on the right side. Laboratory results revealed: haemoglobin 7.6 g/dl, thrombocytes 475 x 109/l, lactate dehydrogenase 1080 U/l, gamma-glutamyltransferase 84 U/l, erythrocyte sedimentation rate 46 mm/h. The other results were normal. Computed tomography of the thorax and abdomen only showed inguinal lymphadenopathy on the right side.