[Acanthosis nigricans as the initial paraneoplastic manifestation of gastric adenocarcinoma]. / Acantosis nigricans como manifestación inicial paraneoplásica de adenocarcinoma gástrico.

We report the case of a 29-year-old man with cutaneous hyperpigmentation located especially in intertriginous areas. The lesions were velvety, rugose and highly pruriginous. The patient was diagnosed with acanthosis nigricans. Initial treatment with topical corticosteroids and oral antihistamines was unsuccessful and, due to suspicion of a paraneoplastic cutaneous syndrome, gastroscopy with sampling for biopsy and abdominal CT were carried out, revealing the existence of an infiltrating gastric adenocarcinoma and underlying adenopathies. The patient underwent total gastrectomy extended to spleen and pancreatic tail and D2 lymph node dissection. Treatment was completed by radiotherapy and chemotherapy to treat lymph node involvement.

Acantosis nigricans como manifestación inicial paraneoplásica de adenocarcinoma gástrico / Acanthosis nigricans as the initial paraneoplastic manifestation of gastric adenocarcinoma

Presentamos el caso clínico de un varón de 29 años de edad con hiperpigmentación cutánea localizada especialmente en las zonas de las flexuras. Eran lesiones aterciopeladas, rugosas y muy pruriginosas. Se diagnosticó de acantosis nigricans. Tras la ineficacia del tratamiento inicial con corticoides tópicos y antihistamínicos orales, y ante la sospecha de afección cutánea paraneoplásica, se realizó una endoscopia oral con toma de muestras para biopsia y tomografía computarizada abdominal, que revelaron la presencia de un adenocarcinoma gástrico infiltrante y adenopatías subyacentes, motivo por el que se sometió al paciente a una gastrectomía total ampliada al bazo y la cola pancreática, y una resección D2 ganglionar. Se completó el tratamiento con radioterapia y quimioterapia por positividad ganglionar

We report the case of a 29-year-old man with cutaneous hyperpigmentation located especially in intertriginous areas. The lesions were velvety, rugose and highly pruriginous. The patient was diagnosed with acanthosis nigricans. Initial treatment with topical corticosteroids and oral antihistamines was unsuccessful and, due to suspicion of a paraneoplastic cutaneous syndrome, gastroscopy with sampling for biopsy and abdominal CT were carried out, revealing the existence of an infiltrating gastric adenocarcinoma and underlying adenopathies. The patient underwent total gastrectomy extended to spleen and pancreatic tail and D2 lymph node dissection. Treatment was completed by radiotherapy and chemotherapy to treat lymph node involvement