Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy.
J Hematol Oncol. 2010 Jan 11;3:2. doi: 10.1186/1756-8722-3-2.
Leser-Trélat syndrome is characterized by the eruptive appearance of multiple seborrheic keratoses in association with underlying malignant disease. Usually, the sign of Leser-Trélat is associated with adenocarcinoma, most frequently of the colon, breast, or stomach, but also of the lung, kidney, liver, and pancreas. Herein, we present a case that we believe is the first report of the sign of Leser-Trélat in association with occult gastric adenocarcinoma and the anamnestic oncologic history of five other multiple primitive cancers. Epidermal growth factor receptor (EGFR) immunohistochemical expression analysis of multiple seborrheic keratoses revealed an intense membranous staining in the basal keratinocytes and in all the upper epidermal layers. Patients with the sign of Leser-Trélat should undergo a diagnostic screening programme for malignant disease along with patients with known Leser-Trélat syndrome who present with a recent acute and florid eruption of their seborrheic keratoses. We propose the importance of combining the molecular features of multiple seborrheic keratoses with EGFR immunohistochemistry analyses to determine the likelihood of Leser-Trélat syndrome and the consequent high risk of underlying multiple visceral malignancies.
莱泽-特雷拉综合征的特征是多发性脂溢性角化病突发出现，同时伴有潜在的恶性疾病。通常，莱泽-特雷拉征与腺癌有关，最常见于结肠、乳腺或胃，但也可见于肺、肾、肝和胰腺。在此，我们报告了一例我们认为是首例与隐匿性胃腺癌和其他五种多发性原始癌既往史相关的莱泽-特雷拉征病例。对多发性脂溢性角化病进行表皮生长因子受体（EGFR）免疫组化表达分析显示，基底角质形成细胞和所有上层表皮层均有强烈的膜染色。莱泽-特雷拉征患者应与已知莱泽-特雷拉综合征患者一起进行恶性疾病的诊断筛查计划，这些患者的脂溢性角化病近期急性和明显发作。我们提出将多发性脂溢性角化病的分子特征与 EGFR 免疫组化分析相结合的重要性，以确定莱泽-特雷拉综合征的可能性以及潜在的多发性内脏恶性肿瘤的高风险。
