Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2020; 8(22): 5632-5638
Published online Nov 26, 2020. doi: 10.12998/wjcc.v8.i22.5632
Malignant acanthosis nigricans with Leser–Trélat sign and tripe palms: A case report
Ning Wang, Peng-Jie Yu, Zhi-Lin Liu, Sheng-Mao Zhu, Cheng-Wu Zhang
Ning Wang, Zhi-Lin Liu, Graduate School, Qinghai University, Xining 810016, Qinghai Province, China
Peng-Jie Yu, Sheng-Mao Zhu, Cheng-Wu Zhang, Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Author contributions: Wang N wrote the paper; Yu PJ, Liu ZL, and Zhu SM designed the study; Zhang CW, Yu PJ, and Wang N performed the operation; All authors read and approved the final manuscript.
Supported by the Focus on Research and Transformation Projects of Qinghai Province, No. 2018-SF-113.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: Our authors declare that we have no competing interests.
CARE Checklist (2016) statement: The guidelines of the “CARE Checklist - 2016: Information for writing a case report” have been adopted.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cheng-Wu Zhang, MD, Chief Doctor, Professor, Surgeon, Department of Gastrointestinal Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China. xtoof@sina.com
Received: July 17, 2020
Peer-review started: July 17, 2020
First decision: August 8, 2020
Revised: August 17, 2020
Accepted: October 12, 2020
Article in press: October 12, 2020
Published online: November 26, 2020
Processing time: 131 Days and 5.6 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Researchers should follow up on patients with malignant AN, Leser–Trélat sign, and tripe palms.

Keywords: Acanthosis nigricans; Leser–Trélat sign; Tripe palms; Paraneoplastic syndrome; Gastric cancer; Case report

Core Tip: Acanthosis nigricans associated with malignant tumor is rare, and mainly occurs in middle-aged and elderly patients. Patients with malignant acanthosis nigricans accompanied by malignant tumor, Leser–Trélat sign, and tripe palms are even rarer. In light of this, references to the clinical features and pathology of various paraneoplastic syndromes, such as malignant acanthosis with Leser–Trélat sign and tripe palms, are very limited.