Malignant Acanthosis Nigricans and Tripe Palms in a Patient with Endometrial Adenocarcinoma—A Case Report and Review of Literature

Gorišek, Borut; Krajnc, Ivan; Rems, D; Kuhelj, Janez

doi:10.1006/gyno.1997.4674

Cited by 26 publications

(22 citation statements)

References 13 publications

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“…This major feature distinguishes it from benign acanthosis nigricans, in which the symmetrically distributed lesions tend to appear at a younger age and do not evolve with time. In addition to systemic features such as weight loss and cachexia, pan may also be seen along with other cutaneous manifestations of internal malignancy, including florid cutaneous papillomatosis 5 , tripe palms 6 , and the sign of Leser-Trélat 2,7,8 . These features, when present, also aid in differentiating between benign acanthosis nigricans and pan.…”

Section: Discussionmentioning

confidence: 99%

Occult Cause of Paraneoplastic Acanthosis Nigricans in a Patient with Known Breast Dcis: Case and Review

Jakubovic¹,

Sawires

Adam

2012

Current Oncology

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bilaterally [ Figure 1(A-B)], the perineum (Figure 2), and neck, although no lymphadenopathy was evident. The features of this exanthem were consistent with a diagnosis of acanthosis nigricans.Given the patient's absence of metabolic risk factors and the rapidity of onset of the cutaneous findings, paraneoplastic acanthosis nigricans (pan) was considered. To our knowledge, pan is most often associated with gastrointestinal tract malignancies and has not been reported in the setting of a ductal carcinoma in situ. Investigations were therefore undertaken to rule out a second occult malignancy that might be a better explanation for the findings.Chest computed tomography (ct) imaging, esophagogastroduodenoscopy, and colonoscopy were all normal, but carbohydrate antigen 19-9 (a tumour marker for pancreatic adenocarcinoma and colorectal cancer) was elevated at 209 kU/L. Abdominal ct revealed a large dilated cystic structure in the gallbladder fossa in which lobulated soft tissue was noted; large masses in the pancreatic bed and porta hepatis were also observed. Marked retroperitoneal adenopathy consistent with metastatic cancer was also noted in the para-aortic region bilaterally.A ct-g uided biopsy of the retroperitoneal lymph nodes demonstrated carcinoma of an undetermined primary. On staining, tumour cells were positive for epithelial membrane antigen and carcinoembryonic antigen, but negative for cytokeratins 7 and 20, estrogen receptor, thyroid transcription factor 1, and calretinin. This staining pattern pointed toward tumours of biliary, pancreatic, and gastric origin, and was not consistent with metastatic breast cancer.The local Tumour Board reviewed the patient's case and concluded that the intra-abdominal findings were most consistent with metastatic cholangiocarcinoma arising from the choledochal cyst. The patient was deemed to have non-curable disease and was offered treatment with palliative chemotherapy. ABSTRACTParaneoplastic acanthosis nigricans (pan) is an infrequently encountered cutaneous manifestation of internal malignancy. Here, we describe a case of pan in the setting of a known breast ductal carcinoma in situ, which, to our knowledge, had not been described in association with pan. As a result, thorough investigation was undertaken to search for another concurrent neoplasm that would better explain the development of pan. In so doing, we identified a coexisting metastatic cholangiocarcinoma. We thus conclude that when pan is observed in an uncommon association with a known malignancy, further investigation should be undertaken to explore whether a more likely occult culprit exists. KEY WORDSAcanthosis nigricans, paraneoplastic acanthosis nigricans, cholangiocarcinoma, ductal carcinoma in situ CASE DESCRIPTIONA 51-year-old woman was seen in consultation in the dermatology clinic for progressive pruritic skin changes affecting the axilla, groin, and neck. She had been referred by her oncologist, who was managing her recently diagnosed breast cancer. Definitive treatment had been initiated and co...

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Section: Discussionmentioning

confidence: 99%

Occult Cause of Paraneoplastic Acanthosis Nigricans in a Patient with Known Breast Dcis: Case and Review

Jakubovic¹,

Sawires

Adam

2012

Current Oncology

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“…1,2 Pertence ao espectro das síndromes paraneoplásicas papuloescamosas e está associada usualmente à neoplasia de órgãos internos, podendo eventualmente ocorrer como manifestação clínica independente. 1,3 A erupção pode regredir ou eventualmente desaparecer com o tratamento da neoplasia e reaparecer com a recorrência da malignidade. 1 A expressão tripe palms foi introduzida em 1977 por Clarke, sendo mais tarde popularizada por Breathnach e Wells.…”

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“…1,3 A erupção pode regredir ou eventualmente desaparecer com o tratamento da neoplasia e reaparecer com a recorrência da malignidade. 1 A expressão tripe palms foi introduzida em 1977 por Clarke, sendo mais tarde popularizada por Breathnach e Wells. 1 Tripe, em inglês, é iguaria preparada a partir do estômago bovino.…”

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“…1 A expressão tripe palms foi introduzida em 1977 por Clarke, sendo mais tarde popularizada por Breathnach e Wells. 1 Tripe, em inglês, é iguaria preparada a partir do estômago bovino. A região palmar dos pacientes acometidos possui aspecto rugoso que pode ser comparado à superfície aveludada do estô-mago bovino.…”

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“…A região palmar dos pacientes acometidos possui aspecto rugoso que pode ser comparado à superfície aveludada do estô-mago bovino. 1 A patogenia da condição ainda não está definitivamente estabelecida. Sabe-se que pode estar relacionada a produtos liberados por células cancerosas, sendo o fator de crescimento alfa (TGF-α) e o fator de crescimento epidérmico os mais prováveis.…”

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Dermatologia comparativa: paquidermatoglifia adquirida associada a carcinoma gástrico avançado

Ribas

Peixoto²,

Almeida³

et al. 2007

An. Bras. Dermatol.

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Resumo: Demonstra-se um caso de paquidermatoglifia adquirida em paciente do sexo masculino, de 67 anos, associada a carcinoma gástrico avançado. Trata-se de síndrome paraneoplásica com manifestações cutâneas que podem ser comparadas à superfície rugosa do estô-mago bovino. Palavras-chave: Ceratodermia palmar e plantar; Neoplasias gástricas; Síndromes paraneoplásicas Paquidermatoglifia adquirida (PA) é ceratodermia palmoplantar não familiar, manifestação cutânea rara caracterizada por espessamento aveludado, acompanhado de aumento pronunciado das linhas e sulcos das superfícies palmar e plantar. 1,2Pertence ao espectro das síndromes paraneoplásicas papuloescamosas e está associada usualmente à neoplasia de órgãos internos, podendo eventualmente ocorrer como manifestação clínica independente.1,3 A erupção pode regredir ou eventualmente desaparecer com o tratamento da neoplasia e reaparecer com a recorrência da malignidade. 1 Tripe, em inglês, é iguaria preparada a partir do estômago bovino. A região palmar dos pacientes acometidos possui aspecto rugoso que pode ser comparado à superfície aveludada do estô-mago bovino. 1 A patogenia da condição ainda não está definitivamente estabelecida. Sabe-se que pode estar relacionada a produtos liberados por células cancerosas, sendo o fator de crescimento alfa (TGF-α) e o fator de crescimento epidérmico os mais prováveis. 4A biópsia de pele demonstra acantose e hiperceratose, podendo ser observada também deposição

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Acanthosis Nigricans with Endometrial Carcinoma: Case Report and Review of the Literature

Mekhail¹,

Markman

2002

Gynecologic Oncology

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Malignant Acanthosis Nigricans and Tripe Palms in a Patient with Endometrial Adenocarcinoma—A Case Report and Review of Literature

Cited by 26 publications

References 13 publications

Occult Cause of Paraneoplastic Acanthosis Nigricans in a Patient with Known Breast Dcis: Case and Review

Occult Cause of Paraneoplastic Acanthosis Nigricans in a Patient with Known Breast Dcis: Case and Review

Dermatologia comparativa: paquidermatoglifia adquirida associada a carcinoma gástrico avançado

Acanthosis Nigricans with Endometrial Carcinoma: Case Report and Review of the Literature

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