Cutaneous clues: Malignant acanthosis nigricans and tripe palms as first signs of recurrent endometrial carcinoma.
Da-Hsin Dzwo, Szu-Wei Huang, Shih-Min Yin et al.
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Case in brief
A 73-year-old woman, disease-free for six years after treatment of stage IB endometrial endometrioid adenocarcinoma, developed acanthosis nigricans and tripe palms. Evaluation for an underlying malignancy, including chest CT, panendoscopy, and colonoscopy, was unrevealing. PET/CT identified a suspicious portocaval lymph node. After laparoscopic excision, pathology confirmed metastatic endometrioid adenocarcinoma with microscopic features consistent with her original tumor.
What made this case unusual
The skin findings were the initial signs of recurrent endometrial carcinoma after six disease-free years; this association is described as uncommon.
Diagnostic / clinical pearl
New acanthosis nigricans and tripe palms can prompt evaluation for internal malignancy, including recurrence in a patient with a remote history of endometrial cancer.