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Malignant Neoplasms and the Leser-Trélat Sign

Richard F. Wagner, Jr, MD; Karen Dineen Wagner, PhD
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Reprint requests to 43 Shebar Dr, Islip, NY 11751 (Dr R. F. Wagner, Jr).


From the Department of Medicine, New York Medical College-Westchester County Medical Center, Valhalla, NY. Dr R. F. Wagner is now with Nassau Hospital, Mineola, NY. Dr K. D. Wagner is now with the State University of New York School of Medicine, Stony Brook.


Arch Dermatol. 1981;117(9):598-599. doi:10.1001/archderm.1981.01650090080036
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The Leser-Trélat sign is characterized by the sudden appearance and rapid increase in both the size and number of seborrheic keratoses. This paraneoplastic syndrome is most frequently associated with adenocarcinoma (67%), with the gastrointestinal (GI) tract being the most common primary tumor site (72%). However, in 22% of cases, the syndrome has been associated with lymphoproliferative malignant neoplasms. We describe herein a patient with the Leser-Trélat sign who had a lymphocytic lymphoma and later was found to have an adenocarcinoma of the large bowel.

Report of a Case  An obese, 59-year-old woman had a recent history of easy fatigability and malaise. Two months before, she had noticed the sudden appearance of many "warts" on her face and neck. On physical examination, multiple, 2- to 6-mm, seborrheic keratoses and numerous pigmented filariform papillomas were present on the neck and malar regions (Figure). Examination of the abdomen disclosed moderate hepatosplenomegaly. Findings from

REFERENCES

Hirata Y, Orth DN:  Epidermal growth factor (urogastrone) in human fluids: Size heterogeneity . J Clin Endocrinol Metab 1979;;48:673-679.
Dantzig PI:  Sign of Leser-Trélat . Arch Dermatol 1973;;108:700-701.
Greer KE, Hawkins H, Hess C:  Leser-Trélat associated with acute leukemia . Arch Dermatol 1978;;114:1552.
Safai B, Grant JM, Good RA:  Cutaneous manifestation of internal malignancies: II. The sign of Leser-Trélat . Int J Dermatol 1978;;17:494-495.
Kechijian P, Sadick NS, Mariglio J, et al:  Cytarabine-induced inflammation in the seborrheic keratoses of Leser-Trélat . Ann Intern Med 1979;;91:868-869.
Navaratnam A, Hodgson GA:  Acanthosis nigricans with carcinoma of the stomach . Br J Dermatol 1973;;89( (suppl 9) ):46-50.
Liddell K, White JE, Caldwell IW:  Seborrhoeic keratoses and carcinoma of the large bowel: Three cases exhibiting the sign of Leser-Trélat . Dr J Dermatol 1975;;92:449-452.
Walter JA, Robinson TWE:  Eruptive basal cell papillomata with carcinoma of caecum . Proc R Soc Med 1972;;65:595-596.
Schwartz RA, Burgess GH:  Florid cutaneous papillomatosis . Arch Dermatol 1978;;114:1803-1806.
Curry SS, King LE:  The sign of Leser-Trélat: Report of a case with adenocarcinoma of the duodenum . Arch Dermatol 1980;;116:1059-1060.

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Hirata Y, Orth DN:  Epidermal growth factor (urogastrone) in human fluids: Size heterogeneity . J Clin Endocrinol Metab 1979;;48:673-679.
Dantzig PI:  Sign of Leser-Trélat . Arch Dermatol 1973;;108:700-701.
Greer KE, Hawkins H, Hess C:  Leser-Trélat associated with acute leukemia . Arch Dermatol 1978;;114:1552.
Safai B, Grant JM, Good RA:  Cutaneous manifestation of internal malignancies: II. The sign of Leser-Trélat . Int J Dermatol 1978;;17:494-495.
Kechijian P, Sadick NS, Mariglio J, et al:  Cytarabine-induced inflammation in the seborrheic keratoses of Leser-Trélat . Ann Intern Med 1979;;91:868-869.
Navaratnam A, Hodgson GA:  Acanthosis nigricans with carcinoma of the stomach . Br J Dermatol 1973;;89( (suppl 9) ):46-50.
Liddell K, White JE, Caldwell IW:  Seborrhoeic keratoses and carcinoma of the large bowel: Three cases exhibiting the sign of Leser-Trélat . Dr J Dermatol 1975;;92:449-452.
Walter JA, Robinson TWE:  Eruptive basal cell papillomata with carcinoma of caecum . Proc R Soc Med 1972;;65:595-596.
Schwartz RA, Burgess GH:  Florid cutaneous papillomatosis . Arch Dermatol 1978;;114:1803-1806.
Curry SS, King LE:  The sign of Leser-Trélat: Report of a case with adenocarcinoma of the duodenum . Arch Dermatol 1980;;116:1059-1060.

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