Caspian Journal of Internal Medicine

en diagnosis of an occult gastric adenocarcinoma by oral manifestations (acanthosis nigricans) : a case report Oncology Oncology case report case report Background: Acanthosis nigricans (AN) is a condition with an important characteristics of symmetrical areas  of thickened skin with grayish brown Hyperpigmentation. The mucosa may show a papillomatous surface, with or without hyperpigmentation. Lips and sites at risk of trauma may be affected and palmoplantar might also be present. In some rare cases, acanthosis nigricans presents as a sign of internal neoplasia, mostly a gastrointestinal cancer, and is called malignant acanthosis nigricans (MAN). Case Presentation: In this study, a 55-year-old female Iranian patient with malignant acanthosis nigricans (MAN) is reported. She was seeking esthetic treatment for her oral and perioral regions. The peculiarity of this case is simultaneous skin manifestation consistent with MAN, “tripe palms,”(TP) , and Leser-Trélat (LT) sign and mucosal changes in the oral cavity such as papillomatosis and roughened surfaces of the lips, hard palate and buccal mucosa. These changes harbored gastric adenocarcinoma stage T3 N3, but the patient was asymptomatic except for pruritis. Conclusion: There is an urgent need to suspect a correlation between oral and skin changes and the possibility of an internal neoplasia, therefore it is of utmost importance to refer these patients for early diagnosis of the underlying disease. This would improve the prognosis and lessen the consequences to a great extent. Gastric adenocarcinoma , Acanthosis Nigricans, Oral manifestations 383 387 http://caspjim.com/browse.php?a_code=A-10-1572-1&slc_lang=en&sid=1 pegah Mosannen Mozafari MosannenP@mums.ac.ir 100319475328460034534 100319475328460034534 No Department of Oral Medicine, School of Dentistry, Oral and maxillofacial Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Roham Salek SalekR@mums.ac.ir 100319475328460034535 100319475328460034535 No Cancer Research Centre Faculty of Medicine Mashhad University of Medical Sciences, Mashhad, Iran Ava Taghizadeh taghizadehra971@mums.ac.ir 100319475328460034536 100319475328460034536 No Department of Oral Medicine, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran Mohammad Javad Yazdanpanah YazdanpanahMJ@mums.ac.ir 100319475328460034537 100319475328460034537 No Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Homan Mosannen Mozaffari MozaffariH@mums.ac.ir 100319475328460034538 100319475328460034538 No Department of Gastroenterology and Hepatology, Mashhad University of Medical Sciences, Mashhad, Iran Elham Esmaeili esmaeilie961@mums.ac.ir 100319475328460034539 100319475328460034539 Yes Department of Oral Medicine, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran