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The Sign of Leser-Trelát and Malignant Acanthosis Nigricans Associated With Fallopian Tube Carcinoma

West, Lindsey, BA; Carlson, Matthew, MD; Wallis, Luke, BA; Goff, Heather W., MD, MPH

doi: 10.1097/AOG.0000000000002920
Contents: Cancer: Case Reports

BACKGROUND: The sign of Leser-Trelát is controversial and rarely reported in gynecologic malignancies. It is characterized by rapid development of new or enlarging seborrheic keratoses.

CASE: A 78-year-old woman presented with unintentional weight loss and new-onset erythematous patches and plaques with thickened, rugated skin and stuck-on brown waxy papules on the chest and back. Her symptoms were concerning for a paraneoplastic eruption; workup revealed an elevated CA 125 level and an ovarian mass on abdominal computed tomography scan. Exploratory laparotomy revealed a stage IIIC serous fallopian tube carcinoma and a synchronous low-grade endometrioid adenocarcinoma of the endometrium.

CONCLUSION: The sign of Leser-Trelát can be associated with fallopian tube carcinoma. When recognized, paraneoplastic dermatoses can prompt clinicians to initiate a workup for occult malignancy.

The sign of Leser-Trelát, when recognized, can prompt clinicians to initiate a workup for occult malignancies, including gynecologic malignancies.

Departments of Dermatology and Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, and the Department of Dermatology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.

Corresponding author: Heather W. Goff, MD, MPH, Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9069; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented as a poster at the Texas Dermatological Society Spring Meeting, April 27–28, 2018, Austin, Texas.

Each author has indicated that he or she has met the journal's requirements for authorship.

Received April 23, 2018

Received in revised form July 20, 2018

Accepted August 02, 2018

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.