Generalized Chronic Itch as a First Sign of Malignancy Resembling Paraneoplastic Sensomotoric Neuropathy

Beigi, M.; Häberle, M.; Gschwendtner, Andreas; Baum, Ulrich; Weißhaar, Elke

doi:10.2340/00015555-2910

Cited by 6 publications

(2 citation statements)

References 12 publications

(16 reference statements)

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“…Malignancies can be accompanied by paraneoplastic symptoms or syndromes, which may be caused by an indirect effect of the malignancy and can represent the first sign of cancer ( 7 ). Pruritus appears as a sign at the beginning of the illness and is accentuated, particularly at night.…”

Section: Discussionmentioning

confidence: 99%

From chronic pruritus to neuroendocrine tumor: A case report

et al. 2022

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Chronic pruritus is a major and distressing symptom of many diseases of dermatological, neurological, psychogenic or systemic origin. This chronic itch could be a presenting sign of malignancy; therefore, paraneoplastic pruritus has also been associated with neuroendocrine tumors (NETs). This article focuses on a patient presenting with chronic pruritus for the past 12 months and who received numerous treatment schemes with very poor clinical improvement, that presented in the hospital for worsening of the chronic pruritus associated with skin rash and significant weight loss (approximately 6 kg over a 2-month period). The laboratory tests showed iron deficiency anemia, eosinophilia and negative tumor markers. In order to investigate the hypoanabolic and anemic syndromes, upper gastrointestinal endoscopy and colonoscopy, which showed no lesions or tumors, were employed. Skin biopsy was performed and antihistaminic and local steroid treatment was initiated. The patient's status worsened within a week and the patient was started on systemic steroid treatment with poor results. Computer tomography was performed to identify any tumor(s) located either in the pelvis or abdomen. A lesion was found in the terminal ileum, identified as a hypervascularized associating bulky lymphadenopathy. The patient was transferred to the surgical ward where right hemicolectomy with manual ileotransverse anastomosis L-L was performed. The histopathological result confirmed NET G2. The patient clinically improved, the skin lesions resolved and the itchiness disappeared. The general status improved significantly. NET G2 diagnosing was possible due to the atypic paraneoplastic sign: chronic pruritus. This case study highlights the association between itch and malignancy and presents an atypical way of NET presentation when all tumor markers remain negative.

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Section: Discussionmentioning

confidence: 99%

From chronic pruritus to neuroendocrine tumor: A case report

et al. 2022

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“…CI can be an additional burden in chronically ill patients leading to an additional reduction in QOL and affecting mortality in patients (14)(15)(16). CI can be a symptom or precursor of another (frequently) severe disease (17), but diagnostics are limited and not accessible in most countries; for example, radiological diagnostics and allergy testing are not reimbursed in many countries or excluded in insurance policy (18,19). Common treatments like antihistamines do not relive itch, even in combination (19,20).…”

Section: Introduction: the Global Burden Of Itchmentioning

confidence: 99%