Zhang Xiaoyan, Liu Rongjun, Liu Yiyun, Zhang Shuang, Qi Hong
Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, 100191, Beijing, PR China.
Department of Ophthalmology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China.
BMC Ophthalmol. 2020 Nov 13;20(1):446. doi: 10.1186/s12886-020-01708-2.
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.
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.
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.
报告一例具有两个不寻常特征的恶性黑棘皮病病例，包括患者年龄较轻以及睑缘出现丝状乳头瘤。
一名30岁女性出现干眼症状。检查发现睑缘、牙龈、嘴唇、手部和腋窝有丝状乳头瘤，颈部、腋窝和腹股沟有色素沉着过度。胃、胰腺和甲状腺病变的活检分别显示胃腺癌、胰腺腺癌和甲状腺癌。全身检查显示胃腺癌伴有转移扩散。该患者最终被诊断为恶性黑棘皮病，4个月后死亡。
睑缘出现天鹅绒样增生的黑棘皮病高度提示存在内部恶性肿瘤，对此类病例应进行全面的全身检查。在该患者中，早期症状被忽视，导致失去了及时诊断和治疗的机会。
