Alopecia neoplastica in a patient with gastric carcinoma

Abstract

A well-recognized but rare presentation of scalp metastasis is alopecia neoplastica, which occurs as a single or multiple areas of cicatricial alopecia. Alopecia neoplastica is usually a presentation of metastasis from breast cancer, and other primary sites are extremely rare. We report a 36-year-old woman with alopecia neoplastica due to metastasis from gastric carcinoma. She also had pelvic metastases. An asymptomatic erythematous alopecic plaque had developed 10 months before presentation and biopsy was consistent with scalp metastasis. Total abdominal hysterectomy and salphingo-oophorectomy was performed and chemotherapy was proposed.

Desmoplastic melanoma presenting as primary alopecia neoplastica: a report of two cases

“…Secondary alopecia neoplastica almost exclusively occurs in females with metastatic breast cancer being the most common etiology by far . Others causes of secondary alopecia neoplastica are more rare and include metastatic malignancies of pulmonary, gastrointestinal or reproductive system origins . A history of previous malignancy and/or the concomitant existence of distant metastases elsewhere may alert the provider to the neoplastic origin of alopecia in these cases.…”

Alopecia neoplastica as a sign of visceral malignancies: a systematic review

“…Regarding the primary site of malignancy, gastrointestinal (GI) tract accounted for 24.4% (30/123), 2,14,16,23,30,32,33,36,46,48,49,56,61,63,64,71,78,79,83,84,88,93,96,98,101,102,105,106,115,118 breast for 17.9% (22/123) of cases, 4,6,7,10,11,13,15,[17][18][19]26,27,29,34,35,37,44,66,67 kidney for 8.1% (10/123), lung for 7.3% (9/ 123), 25,38,43,<...>…”

“…Median time between primary tumour and AN diagnosis was 10 months (ranging from 0 to 240 months; IQR: 0-36). Finally, AN was the first metastatic event in 65 cases, 6,9,11,12,16,17,[19][20][21][22]24,28,34,36,37,39,41,51,54,56,60,62,67,70,72,[74][75][76][77]79,80,84,86,92,93,109,115,[117][118][119]121 with a median number of 1 lesion (ranging from 1 to 8) and a median diameter of 3 cm (ranging from 1 to 20 cm; IQR:1.5-4.7).…”

“…Regarding clinical appearance, AN was identified as a nodule, plaque and patch in 58% (69/119), 8,9,21,22,24,27,33,34,37-41,43,44,46,47,49- 2,6,7,11,[14][15][16][17][18][19][20]23,25,29,67,96 respectively; under the general term of a 'mass' in 16.8% (20/119) 28,32,35,42,45,48,58,59,71,73,80,81,83,87,95,106,110,111,114,117 and as an 'excoriated lesion' in 2.5% (3/119) of cases. 69,78,109 Specifically, breast cancer was mainly associated with patch lesions (9/20), followed by plaques and nodules (five and five out of 20, respectively).…”

“…Ulceration (histologically diagnosed) was present in 31 out of 94 cases (33%), 13,15,26,[28][29][30][31]34,38,42,46,52,56,60,68,69,72,[76][77][78]80,84,92,95,97,102,106,109,114,116,117 with a higher incidence in AN related to lung cancer (4/5 cases). 68,69,72,77 The main colour of AN lesions was red-violaceous (66.7% -66/99), 2,4,6,8,9,12,13,15,17,20,21,27-29,34,40,42,43,46,47,50,53,55,57,59,61,63,65,67,68,70,71,73,75,76,78,80,83,85-89,91-93, 95-100,102,104,105,108-110,113,115-118,120,121 followed by flesh-coloured in 25.3% (25/99) 10,11,14,16,19,[23][24][25]32,33,36,45,…”