Wang Ning, Yu Peng-Jie, Liu Zhi-Lin, Zhu Sheng-Mao, Zhang Cheng-Wu
Graduate School, Qinghai University, Xining 810016, Qinghai Province, China.
Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China.
World J Clin Cases. 2020 Nov 26;8(22):5632-5638. doi: 10.12998/wjcc.v8.i22.5632.
Acanthosis nigricans (AN), Leser-Trélat sign, and tripe palm are all skin diseases. To date, reports of these appearing as a paraneoplastic syndrome in a gastric cancer patient are quite rare.
We report the case of a 61-year-old man with darkened skin color in the face and torso with no obvious inducement after 1 year of treatment for Riehl's melanosis. He had 40 brown maculopapular eruptions on his face and the top of his head with obvious itching. Papillary wart-like hyperkeratosis with dark brown pigmentation was also observed on both sides of the areola. He had papilloma-like lesions on the face, around the orbit, and on the neck. His bilateral palms had small, smooth, papillary projections with millet-like appearance. Histopathological examination of the skin showed that the patient was suffering from AN, tripe palms, and Leser-Trélat sign. Gastroscopy showed the patient's cardia was affected, and pathological biopsy revealed that he had moderate-to-poorly differentiated adenocarcinoma. Computed tomography test results showed that his cardia wall had thickened. Based on these histological and skin characteristics, the patient was diagnosed with gastric cancer with AN, tripe palms, and Leser-Trélat sign.
Researchers should follow up on patients with malignant AN, Leser-Trélat sign, and tripe palms.
黑棘皮病(AN)、Leser-Trélat征和掌跖角化瘤均为皮肤疾病。迄今为止,这些疾病作为副肿瘤综合征出现在胃癌患者中的报道相当罕见。
我们报告了一名61岁男性的病例,该患者在接受瑞尔黑变病治疗1年后,面部和躯干皮肤颜色变黑,无明显诱因。他的面部和头顶有40个褐色斑丘疹,伴有明显瘙痒。乳晕两侧还观察到乳头状疣状角化过度并伴有深褐色色素沉着。他的面部、眼眶周围和颈部有乳头状瘤样病变。他的双侧手掌有小米粒样的小而光滑的乳头状突起。皮肤组织病理学检查显示该患者患有黑棘皮病、掌跖角化瘤和Leser-Trélat征。胃镜检查显示患者贲门受累,病理活检显示他患有中分化至低分化腺癌。计算机断层扫描检查结果显示他的贲门壁增厚。基于这些组织学和皮肤特征,该患者被诊断为患有伴有黑棘皮病、掌跖角化瘤和Leser-Trélat征的胃癌。
研究人员应对患有恶性黑棘皮病、Leser-Trélat征和掌跖角化瘤的患者进行随访。