Sweet syndrome in patients with solid tumors

Abstract

Background. Sweet syndrome (acute febrile neutrophilic dermatosis) may occur as a cutaneous paraneoplastic syndrome. This condition has been associated with hematologic malignancies and, to a lesser extent, with solid tumors. Methods. The authors report two patients with malignancy‐associated Sweet syndrome: a 66‐year‐old man in whom the onset of Sweet syndrome preceded the diagnosis of an adenocarcinoma of unknown primary by 3 months and a 69‐year‐old woman in whom a workup after the appearance of Sweet syndrome skin lesions revealed an unsuspected recurrent squamous cell carcinoma of the larynx. The authors review the reports of the other 39 patients with solid tumor‐associated Sweet syndrome that have been published in the world literature. Results. The most common malignancies were carcinomas of the genitourinary organs (37%), breast (23%), and gastrointestinal tract (17%). Typical clinical features and laboratory findings in these patients included tender erythematous plaques located on the upper extremities (97%); elevated erythrocyte sedimentation rate (95%); anemia (83%); fever (79%); and neutrophilia (60%). The symptoms and lesions of Sweet syndrome resolved after treatment with corticosteroids, potassium iodide, or colchicine. Sweet syndrome preceded the initial diagnosis of cancer or the detection of asymptomatic metastatic, persistent, or recurrent tumor, or a hematologic malignancy (in an individual with a previously diagnosed solid tumor) in 61% of the patients. In the other 39% of patients, diagnosis of Sweet syndrome followed the development of a solid tumor. Conclusion. The search for a neoplasm of the genitourinary organs and breast cancer in women and a gastrointestinal tract carcinoma in men should be emphasized in the evaluation for a solid tumor in patients with Sweet syndrome without a prior diagnosis of malignancy.

Localized Sweet's Syndrome in an Irradiated Field

“…The disease is thought 1 . In contrast with idiopathic Sweet's syndrome, patients with malignancyassociated Sweet's syndrome tend to develop more severe skin lesions with involvement of the mucous membranes or other extracutaneous sites, neutrophilia is typically absent, anemia and abnormal platelet counts are frequent, and there is a high rate of recurrence 8,9 .…”

Sweet's syndrome in prostate cancer

“…The solid tumours most commonly reported in association with SS include genitourinary, breast and gastroinstestinal tract carcinomas. [2][3][4] Sweet's syndrome has previously been reported in association with prostate cancer but as far as we are aware, only once previously as the sole causative agent. 5 In the other reported cases, new haematological diagnoses (erythroleukaemia, acute myeloid leukaemia and myelodysplasia) were found to be related to the first episode of SS or other comorbid transitional cell carcinoma bladder were present.…”

“…5 In the other reported cases, new haematological diagnoses (erythroleukaemia, acute myeloid leukaemia and myelodysplasia) were found to be related to the first episode of SS or other comorbid transitional cell carcinoma bladder were present. 4,[6][7][8] This raises some doubt about the aetiological significance of prostate cancer for these cases. The diagnosis of SS can often precedes that of new malignancy or metastasis by up to 1 year.…”

“…The diagnosis of SS can often precedes that of new malignancy or metastasis by up to 1 year. 2,4 However, in about 39% of cases the temporal relationship is reversed. It is, therefore, not unreasonable to suggest that SS is associated with prostate adenocarcinoma cancer in this case.…”

A Case of Sweet's Panniculitis Associated with Spinal Metastasis from Prostate Cancer

“…The most common associated malignancy is acute myelogenous leukemia, and solid tumors account for only 15% of the malignancy-associated cases of Sweet's syndrome 6 . Sweet's syndrome precedes or coincides with the detection of primary, metastatic or recurrent tumors in 61% of the patients diagnosed with solid tumors, and occurs after the development of a solid tumor in remaining 39% of the patients 7 . The time interval between the diagnosis of a solid tumor and occurrence of Sweet's syndrome was highly variable, up to 131 months 7 .…”