Acanthosis Nigricans associated with clear-cell renal cell carcinoma

Abstract

Acanthosis nigricans (AN), an entity recognized since the 19th century, is a dermatopathy associated with insulin-resistant conditions, endocrinopathies, drugs, chromosome abnormalities and neoplasia. The latter, also known as malignant AN, is mostly related to abdominal neoplasms. Malignant AN occurs frequently among elderly patients. In these cases, the onset is subtle, and spreading involves the flexural regions of the body, particularly the axillae, palms, soles, and mucosa. Gastric adenocarcinoma is the most frequent associated neoplasia, but many others have been reported. Renal cell carcinoma (RCC), although already reported, is rarely associated with malignant AN. The authors report the case of a woman who was being treated for depression but presented a long-standing and marked weight loss, followed by darkening of the neck and the axillary regions. Physical examination disclosed a tumoral mass in the left flank and symmetrical, pigmented, velvety, verrucous plaques on both axillae, which is classical for AN. The diagnostic work-up disclosed a huge renal mass, which was resected and further diagnosed as a RCC. The post-operative period was uneventful and the skin alteration was evanescent at the first follow-up consultation. The authors call attention to the association of AN with RCC.

Bullous pemphigoid, malignant acanthosis nigricans, and erysipeloid carcinoma in a woman with gastric adenocarcinoma

“…Malignant AN occurs in elderly patients with a rapidly, progressive velvety thickening of the flexural skin surfaces and oral mucosa unlike the younger, slowly occurring benign AN but patients as young as 30 years old with malignant AN has been reported. 8 Malignant AN has a well‐established association with internal malignancies, especially gastric adenocarcinoma, but an association with clear cell lung carcinoma, 9 bladder carcinoma, 10 pancreatic, ovary, esophageal, and renal cell carcinoma have also been reported. 11 The co‐existence of AN and BP had been rarely described.…”

The Cellular Stress and Cutaneous Manifestations in Renal Cell Carcinomas—A Narrative Review

“…A paraneoplastic variant can often be differentiated from other variants of acanthosis nigricans by its extensive lesions on the skin and mucous membranes, rapid progression, and onset usually in middle age. The coexistence of acanthosis nigricans and RCC is explained by the hyperstimulation of keratinocytes induced by the action of excess TNF-α on VEGFR [87,88].…”