Acanthosis Nigricans associated with clear-cell renal cell carcinoma.
Acanthosis nigricans (AN), an entity recognized since the 19th century, is a dermatopathy associated with insulin-resistant conditions, endocrinopathies, drugs, chromosome abnormalities and neoplasia. The latter, also known as malignant AN, is mostly related to abdominal neoplasms. Malignant AN occurs frequently among elderly patients. In these cases, the onset is subtle, and spreading involves the flexural regions of the body, particularly the axillae, palms, soles, and mucosa. Gastric adenocarcinoma is the most frequent associated neoplasia, but many others have been reported. Renal cell carcinoma (RCC), although already reported, is rarely associated with malignant AN. The authors report the case of a woman who was being treated for depression but presented a long-standing and marked weight loss, followed by darkening of the neck and the axillary regions. Physical examination disclosed a tumoral mass in the left flank and symmetrical, pigmented, velvety, verrucous plaques on both axillae, which is classical for AN. The diagnostic work-up disclosed a huge renal mass, which was resected and further diagnosed as a RCC. The post-operative period was uneventful and the skin alteration was evanescent at the first follow-up consultation. The authors call attention to the association of AN with RCC.
Internal Medicine Division - Hospital Universitário - University of São Paulo, São Paulo/SP - Brazil .
Fernando Peixoto
FP
Ferraz de Campos
Neurology Department - Hospital das Clínicas - University of São Paulo, São Paulo/SP - Brazil .
Margarita Rosa Aveiga
MR
Narvaez
Internal Medicine Department - Hospital das Clínicas - University of São Paulo, São Paulo/SP - Brazil .
Paola Vasconcellos Soares
PV
Reis
Internal Medicine Department - Hospital das Clínicas - University of São Paulo, São Paulo/SP - Brazil .
Augusto Cesar Marins
AC
Gomes
Infectious Diseases Institute - Hospital Emílio Ribas, São Paulo/SP - Brazil .
Daniela Kallíope de Sá
DK
Paraskevopoulos
Pathology Department - Faculty of Medicine - University of São Paulo, São Paulo/SP - Brazil .
Frederico
F
Santana
Surgery Division - Hospital Universitário - University of São Paulo, São Paulo/SP - Brazil .
Oscar Eduardo Hidetoshi
OE
Fugita
Acanthosis nigricans; Carcinoma, Renal Cell; Paraneoplastic Syndromes