Liu Zijian, Cao Wuling, Liu Yang
Department of Periodontics, Stomatological Hospital of Xiamen Medical College & Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, China.
Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.
Front Oncol. 2024 Sep 24;14:1459148. doi: 10.3389/fonc.2024.1459148. eCollection 2024.
Almost all cases of malignant acanthosis nigricans with oral manifestations occurred in older age groups. Here, we report a case of malignant acanthosis nigricans in a young female presented with chief complaints of oral mucosal hyperplasia, who had previously been diagnosed with allergies.
A 30-year-old female developed oral hyperplasia and rash following seafood consumption, with subsequent resolution of the rash but persistent oral lesions and the appearance of pigmentation on her hands, neck, and axillae. Clinical examination revealed papillomatosis, hyperemia, and velvety hyperplasia in the oral cavity. Biopsy results confirmed papillary hyperplasia. Despite the patient's belief in good health, she was advised to undergo further systemic examinations. Elevated serum tumor markers and histologic analysis of an endoscopic biopsy confirmed gastric cancer with duodenal infiltration, leading to the diagnosis of malignant acanthosis nigricans. Unfortunately, the patient passed away due to heart failure during chemotherapy treatment.
The majority of patients with malignant acanthosis nigricans present with oral lesions before the underlying malignancy is detected, emphasizing the importance of timely comprehensive systemic examination. Furthermore, our case suggests that age may not be a restrictive factor for the development of malignant acanthosis nigricans, and the presence of a rash can potentially obscure the cutaneous manifestations associated with this condition.
几乎所有伴有口腔表现的恶性黑棘皮病病例都发生在老年人群中。在此，我们报告一例年轻女性的恶性黑棘皮病病例，该患者主要表现为口腔黏膜增生，此前曾被诊断为过敏。
一名30岁女性在食用海鲜后出现口腔增生和皮疹，随后皮疹消退，但口腔病变持续存在，且双手、颈部和腋窝出现色素沉着。临床检查发现口腔内有乳头瘤病、充血和天鹅绒样增生。活检结果证实为乳头状增生。尽管患者自认为身体健康，但仍建议其进行进一步的全身检查。血清肿瘤标志物升高以及内镜活检的组织学分析证实为胃癌伴十二指肠浸润，从而诊断为恶性黑棘皮病。不幸的是，患者在化疗期间因心力衰竭去世。
大多数恶性黑棘皮病患者在潜在恶性肿瘤被发现之前就出现口腔病变，这凸显了及时进行全面全身检查的重要性。此外，我们的病例表明年龄可能不是恶性黑棘皮病发生的限制因素，皮疹的存在可能会掩盖与此病相关的皮肤表现。
