SHM Converge Scientific Abstract ePoster Gallery-Skin Talks: Leser-Trélat Sign as a Harbinger of Ovarian Malignancy

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This case report describes Leser-Trélat sign, a rare cutaneous paraneoplastic syndrome marked by the sudden appearance and rapid increase of multiple seborrheic keratoses. A 64-year-old woman presented with one day of lower abdominal pain, nausea, and vomiting. On exam, she had a distended tender abdomen and newly developed waxy brown-to-tan papules and plaques on her back. Tumor markers CA 19-9, CA 125, and beta-hCG were elevated, while CEA was normal. CT imaging revealed an 8.3 cm left adnexal mass. GI workup with colonoscopy and upper endoscopy was negative.<br /><br />She underwent diagnostic laparoscopy, exploratory laparotomy, and extensive debulking of the ovarian tumor. Pathology showed mixed carcinoma, predominantly clear cell carcinoma with a smaller endometrial carcinoma component. She is now receiving adjuvant chemotherapy.<br /><br />The report emphasizes that Leser-Trélat sign may indicate an underlying malignancy, most commonly gastrointestinal cancers, especially gastric adenocarcinoma, though it can also occur with other internal cancers such as ovarian malignancy. The skin findings are thought to result from cytokines and growth factors released by the tumor. Clinicians should recognize this sign because a careful skin examination may provide an early clue to occult cancer and prompt timely evaluation.

Asset Subtitle

Navin Bhatt

Meta Tag

Author List Maryam Hajiabbasi, Nagma Shah, Navin Bhatt, Shristi Nepal

Category Clinical Vignettes

Concept Leser-Trélat Sign

Concept Seborrheic Keratosis

Concept Paraneoplastic Marker

Concept Gastric Adenocarcinoma

Concept Malignancy

Distinguished Non-Finalist

Presenter Organization Icahn School of Medicine at Mount Sinai / Elmhurst

Presenting Author Navin Bhatt

Track Adult

Keywords

Leser-Trélat sign

seborrheic keratoses

paraneoplastic syndrome

ovarian cancer

clear cell carcinoma

endometrial carcinoma

tumor markers

adnexal mass

cutaneous manifestation

occult malignancy

Leser-Trélat Sign

Seborrheic Keratosis

Paraneoplastic Marker

Gastric Adenocarcinoma

Malignancy