Malignant acanthosis nigricans: a case report

Abstract

Background To report a case of malignant acanthosis nigricans with two unusual aspects, including the patient’s young age and the development of filiform papillomas on the eyelid margins. Case presentation A 30-year-old woman presented with dry eye symptoms. Examination revealed filiform papillomas on the eyelid margins, gums, lips, hands, and axillae and excessive pigmentation localized to the neck, axillae, and groin. Biopsies of stomach, pancreatic, and thyroid lesions revealed gastric adenocarcinoma, pancreatic adenocarcinoma, and thyroid cancer, respectively. Systemic investigations showed gastric adenocarcinoma with metastatic spread. The patient was ultimately diagnosed with malignant acanthosis nigricans and died 4 months later. Conclusions Acanthosis nigricans on the eyelid margins with a velvety overgrowth is highly suggestive of an internal malignancy, and full systemic investigations are warranted in these cases. In this patient, early signs were ignored, leading to the loss of a timely diagnosis and treatment.

Correlated improvement of mucosal malignant acanthosis nigricans and metastatic urothelial carcinoma with oncologic therapy

“…There are also several reports that do not comment on the course of cutaneous findings, in some cases due to rapid clinical deterioration and ultimately patient death. 5 , 7 In our case, the patient’s malignant AN resolved with treatment of the underlying malignancy. Because we were able to evaluate her clinical findings before her next scheduled surveillance imaging, we speculated that her cutaneous improvement would predict oncologic improvement as well.…”

“…Malignant acanthosis nigricans (AN) is a rare paraneoplastic phenomenon, most often associated with underlying gastrointestinal malignancy. 1 , 2 There are several reports of this entity and its diagnostic challenges in the literature, 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 but the course of cutaneous manifestations is not well-defined, making it difficult to counsel patients regarding potential clinical outcomes. In this article, we report a case of malignant AN, presenting as mucosal papillomatosis, with near-complete resolution correlated with treatment of the underlying malignancy.…”

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

“…Meanwhile, malignant AN was of a true paraneoplastic disease with nearly complete resolution after chemotherapy of the adenocarcinoma and slow reappearance just before she developed erysipelas‐like plaque of the right thigh. 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 .…”

Acanthosis Nigricans: Pointer of Endocrine Entities

“…Beyond traditional endocrine tumors and neuroendocrine neoplasia, MAN has been reported in gastric and pulmonary adenocarcinomas, ovarian and breast carcinoma, cholangiocarcinoma, and liver malignancy [ 171 , 172 , 173 , 174 , 175 ]. One case of a 30-year-old female was admitted for MAN, which was underlying synchronous gastric, pancreatic, and thyroid cancer with rapid progression that, within months, led to a fatal outcome [ 176 ]. MAN has a rapid onset, and is not asymptomatic as traditional AN; it is associated with pruritus and may spread to oral cavities with local effects [ 177 ].…”