Abstract: 【Abstract】 Objective To investigate the clinical characteristics of patients with limb lymphedema complicated with skin malignant tumors. Methods It was a case series study. A total of 16 patients with limb lymphedema complicated with skin malignant tumors who were admitted to the Department of Lymphatic Surgery, Beijing Shijitan Hospital, Capital Medical University, from March 2017 to March 2023 were selected, and their clinical characteristics were analyzed. Results Among the 16 patients, there were 3 males and 13 females, aged 64.1 ± 9.6 （39 - 79） years. The main clinical manifestation was the presence of palpable solitary or multiple cutaneous/subcutaneous nodules in lymphedematous limbs, among which 7 patients experienced pain in the skin lesions. All 16 patients underwent excisional biopsy of skin lesions or ultrasound-guided needle biopsy. Pathological examination showed 10 cases of angiosarcoma, 1 case of squamous cell carcinoma, 2 cases of cutaneous metastases from breast cancer, and 3 cases of cutaneous metastases from gastric signet ring cell carcinoma. Among the 11 patients with limb lymphedema secondary to skin malignant tumors, 5 underwent amputation, 1 received chemotherapy, 1 received oral targeted therapy, and the remaining 4 received palliative treatment. Among the 5 patients with cutaneous metastatic carcinoma, 3 received chemotherapy, 1 received chemotherapy combined with immunotherapy, and 1 received oral traditional Chinese medicine treatment. Follow-up was conducted until June 2024. Among the 11 patients with limb lymphedema secondary to skin malignant tumors, 4 achieved progression-free survival, 1 survived with tumor progression, and 6 died. Among the 5 patients with cutaneous metastatic carcinoma, 1 achieved progression-free survival, and 4 died. Conclusions Limb lymphedema complicated with skin malignant tumors is clinically rare and is associated with a poor prognosis. For patients with newly developed skin malignant tumors in lymphedematous limbs, amputation may improve prognosis. For patients with lymphedema complicated with cutaneous metastatic carcinoma, chemotherapy may be the preferred treatment option.

Key words: Lymphedema, Skin mass, Angiosarcoma, Signet ring cell carcinoma, Breast cancer, Therapy, Prognosis