Oral Malignant Acanthosis Nigricans and Tripe Palms Associated With Renal Urothelial Carcinoma

Acanthosis Nigricans associated with clear-cell renal cell carcinoma

“… 36 Searching the PubMed database (irrespective of the period), using the keywords “acanthosis nigricans” crossed with “clear cell carcinoma,” “urothelial carcinoma,” “kidney,” “renal carcinoma,” and “paraneoplastic,” we found 168 citations related to malignant AN—among them the association with renal malignancy are described as follows. In the Riegel and Jacobs series, 36 which comprised 277 cases of malignant AN, only 1 case of renal malignancy was reported; Moscardi et al 37 reported a case of renal malignancy without histological identification; and Lee et al 38 reported a case of renal urothelial carcinoma and AN. Therefore, we conclude that this association is very rare or at least under-reported.…”

Oral Verrucous Plaques in a Patient With Urothelial Cancer

“…Although most cases (80%) are associated with idiopathic or benign conditions, the link between acanthosis nigricans and an underlying malignancy has been well documented. [1][2][3] Most commonly associated with an underlying intra-abdominal malignancy (often gastric carcinoma), the lesions of paraneoplastic acanthosis nigricans are indistinguishable from their benign counterparts. 1,4 When the condition presents abruptly and extensively in a nonobese patient, prompt workup for malignancy should be initiated.…”

Paraneoplastic Signs in Bladder Transitional Cell Carcinoma: An Unusual Presentation

“…With no malignancy identified over the preceding 6-month period, treatment with acitretin 50 mg daily was initiated based on limited literature support. [1][2][3] Treatment led to reduction in the size and number of papillomas (Figure 1B) and tripe palms (Figure 2B) with increased mobility of hands, lips, and tongue. The patient underwent oculoplastic surgery to reduce the papilloma burden along the eyelid margins.…”

“…1,11,[14][15][16][17] Two additional reports described tripe palms with oral acanthosis nigricans and progressive mucocutaneous papillomatosis in metastatic gastric adenocarcinoma and renal urothelial carcinoma. 2,18 An additional case of all 3 paraneoplastic conditions was reported in the setting of metastatic cervical cancer (HPV positive). 19 Per a recent case report and literature review, 20 there have only been 8 cases of acanthosis nigricans reported in bladder transitional cell carcinoma, [20][21][22][23][24][25][26][27] half of which have included oral malignant acanthosis nigricans.…”

“…While previous cases have reported use of retinoids at a lower dosage than used in this case, oral lesions often have only been mildly improved with little impact on other cutaneous symptoms. 1,2 In one case of malignant acanthosis nigricans and oral papillomatosis, isotretinoin 25 mg once every 2 to 3 days led to a moderate decrease in hyperkeratosis and papillomas, but the patient was lost to follow-up. 3 Our case highlights the use of higher daily doses of oral retinoids for over 9 months, resulting in marked improvement in both the mucosal and cutaneous symptoms of acanthosis nigricans, progressive mucocutaneous papillomatosis, and tripe palms.…”