Tripe Palms and Malignant Acanthosis Nigricans: Cutaneous Signs of Imminent Metastasis in Bladder Cancer?

Möhrenschlager, M.; Vocks, E.; Wessner, D.; Nährig, Jörg; Ring, J.

doi:10.1016/s0022-5347(05)66369-0

Cited by 20 publications

(12 citation statements)

References 3 publications

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“…Most often involved tumors are carcinomas (gastric especially), sarcomas and hematological proliferations. The occurrence of AN is rarely reported in urological cancers, such as RCC, BCa and PCa, and seems to be an indicator of a bad prognosis [25][26][27] .…”

Section: Acanthosis Nigricansmentioning

confidence: 99%

Paraneoplastic Syndromes in Patients with Urological Malignancies

et al. 2009

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Introduction: Paraneoplastic syndromes (PNS) may represent the main clinical problem in cancer patients; however, the knowledge of their clinical aspect remains quite poor among urologists. Objective: To provide urologists with an overview on main clinical aspects of PNS that have been reported to be associated to urological cancers. Methods: Literature search of peer-reviewed papers published by July 2008. Results: All genitourinary tumors can cause a PNS, and renal cell carcinoma is the most frequent urological malignancy involved. Prostate cancer is the second urological tumor associated with PNS which, conversely, are uncommon in bladder cancer and rare in testicular cancer. Tumor neuroendocrine differentiation is involved in most endocrine PNS. Neurologic PNS are very uncommon but may dominate the clinical picture and need a high suspicion index to be recognized. Important advances have been made on radionuclide scan methods in order to detect the primary tumor. The most effective treatment strategy is always represented by the radical therapy of the underlying cancer, but specific therapeutic options are sometimes available. Conclusions: Endocrine PNS are frequently associated with urological cancers, especially renal and prostate carcinoma. PNS have been rarely reported in association with cancers of bladder, urethra and testicle.

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Section: Acanthosis Nigricansmentioning

confidence: 99%

Paraneoplastic Syndromes in Patients with Urological Malignancies

et al. 2009

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“…Among the neoplastic associations with pan, abdominal carcinomas are the most frequent (the preponderance being gastric adenocarcinomas 2,9,10 ), although a broad spectrum of cancers have been documented, including (but not limited to) neoplasia of the urinary bladder 11 , esophagus 12 , adrenals 13 , lung 5 , liver 14 , gall bladder 15 , ovaries 7 , and endometrium 6,16 . In the context of breast carcinoma, pan is rare 10 .…”

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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“…The malignancy is most commonly (90%) an abdominal cancer, up to two-thirds of which are gastric adenocarcinoma [2]. Other cases are lung, bladder [3], endometrial, adrenal [4], bile duct [5], renal, thyroid, lymphoid, breast, hepatocellular, laryngeal, cervical, prostate, testicular, ovarian [6]. and pituitary cancer, sarcoma, or other gastrointestinal malignancy.…”

Section: Discussionmentioning

confidence: 99%

“…The skin symptoms frequently appear before the onset of any other symptoms of malignancy; therefore, it is not rare that the malignancy was diagnosed after the diagnosis of the acanthosis nigricans. The most common malignancies are reported to be adenocarcinoma [1,2], and then squamous cell carcinoma, lymphoma, sarcoma, and others [3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Malignant acanthosis nigricans with esophageal cancer

et al. 2009

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A 62-year-old woman was referred to our hospital with presenting pigmentation and/or dermal thickening in the nucha, face, axilla, abdomen, and hands. She also presented a history of weight loss of 4 kg during the previous 3 months. She was pathologically diagnosed as having acanthosis nigricans by skin biopsy. She subsequently underwent 18 F-FDG-PET, CT, and upper gastrointestinal endoscopy, and then was diagnosed as having malignant acanthosis nigricans with squamous cell carcinoma in the esophagus at the clinical stage of T3, N0, M0, stage IIA in the UICC stage classifi cation. She underwent subtotal esophagectomy through a left thoracotomy with thoracoabdominal two-fi eld lymphadenectomy and esophageal reconstruction using a gastric tube through a retrosternal route. The postoperative course was uneventful, and she was discharged at 26 days after the surgery without any adjuvant therapy. At 6 months after the surgery, the dermal thickening and the pigmentation of the acanthosis nigricans were completely relieved. She is well without recurrence at 1 year to date after surgery. Although acanthosis nigricans is frequently associated with malignancy, malignant acanthosis nigricans with squamous cell carcinoma in the esophagus has been rare.

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Tripe Palms and Malignant Acanthosis Nigricans: Cutaneous Signs of Imminent Metastasis in Bladder Cancer?

Cited by 20 publications

References 3 publications

Paraneoplastic Syndromes in Patients with Urological Malignancies

Paraneoplastic Syndromes in Patients with Urological Malignancies

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

Malignant acanthosis nigricans with esophageal cancer

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