Leser-Trélat sign presenting in a patient with ovarian cancer: a case report

Abstract

IntroductionSeborrheic keratoses are very common findings in elderly patients. However, a sudden onset and dramatic increase in the number and size of these benign lesions deserves special attention, since this may represent the Leser Trélat sign, a rare paraneoplastic cutaneous syndrome.Case presentationA 92-year-old female presented to our clinic with multiple eruptive seborrheic keratoses, which had dramatically increased in size and number over the past two years. A diagnostic work-up revealed an ovarian carcinoma. Hence, cutaneous findings in our patient were consistent with the diagnosis of the Leser-Trélat sign.ConclusionThe Leser-Trélat sign may coincide with the diagnosis of occult cancer or follow or precede it by months or years. Practitioners should take cases of eruptive seborrheic keratoses seriously and perform thorough patient examinations.

El signo de Leser-Trélat ¿Un predictor de neoplasias útil en clínica?

“…La gran mayoría de los artículos hallados corresponden al informe de uno o pocos pacientes con queratosis seborreica eruptiva y alguna neoplasia, generalmente gastrointestinal y pancreatobiliar , aunque hay casos de la lesión cutánea asociada a linfoma de células T, linfoma no Hodgkin, leucemia mieloide o linfoide crónica, melanoma; cáncer en pulmón, útero, mama, ovario, próstata, riñón, vejiga, nasofaringe, médula espinal, tiroides y hueso (3,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46). Aunque menos, también hay publicaciones de pacientes con la lesión dermatológica y condiciones como hiperinsulinismo, eritrodermia, trasplante cardiaco, tratamiento con citarabina o adalimmumab, VIH, adenoma de células Figura 1.…”

Eruptive seborrheic keratosis: A perilous clue

“…Another suggests that extracellular matrix components, such as glycosaminoglycans released from stroma of the tumor, become incorporated in distant normal skin, causing epithelial alteration and eruption of seborrheic keratoses. 5 The Leser-Trélat sign may be the initial presentation, or it can be detected concurrently with or after diagnosing an internal malignancy. Eruptive seborrheic keratoses can occur anywhere, but the most common sites are the back, chest, and extremities.…”