Two Cases of Early Gastric Cancer and Advanced Rectal Cancer with the Sign of Leser-Trélat

Tomoki Tokugawa, Yoshitaka Yamamura, Akihito Torii, Yasuhiro Shimizu, Yasuhiro Kodera, Takashi Hirai, Kenzo Yasui, Takeshi Morimoto, Tomoyuki Kato and Tsuyoshi Kito

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital

The sign of Leser-Trélat which belongs to paraneoplastic dermatoses is defined as sudden appearance and rapid increase in size and number of seborrheic keratoses. Two cases of cancer of the gastrointestinal tract with the sign of Leser-Trélat are reported. Case 1: A 73-year-old man visited the Department of Dermatology at our hospital because of rapid proliferation of seborrheic keratosis with itching on his neck. A diagnosis of the sign of Leser-Trélat was made, followed by probing for any malignant tumor of the viscera, which disclosed a IIc lesion on the posterior wall of the gastric upper body. Proximal gastrectomy was performed. The histological findings were classified as moderately differentiated tubular adenocarcinoma stage I according to the Japanese Classification of Gastric Carcinoma by the Japanese Research Society for Gastric Cancer. Case 2: A 72-year-old man visited the Department of Gastroenterological Medicine at our hospital because of anorexia and narrow stools. At the same time he developed the sign of Leser-Trélat. Biochemical examination rerealed occult blood in the stool so we referred him for lower intestinal endoscopy and radiographic examinations. By these examinations type 2 cancer was found in the rectosigmoid region. A low anterior resection was performed. The histological findings were classified as moderately differentiated adenocarcinoma stage IIIa according to the Japanese Classification of Colorectal Carcinoma by the Japanese Society for Cancer of the Colon and Rectum. The sign of Leser-Trélat is frequently associated with adenocarcinoma of the gastrointestinal tract and appears to be clinically significant.

Key words
sign of Leser-Trélat, paraneoplastic dermatoses, seborrheic keratosis

Reprint requests
Tomoki Tokugawa Department of Gastroenterological Surgery, Aichi Cancer Center Hospital 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681 JAPAN

Accepted
April 28, 1999

To read the PDF file you will need Abobe Reader installed on your computer.