ABSTRACT
Usually gastrointestinal malignancies present with low SAAG ascites. But when there is diffuse liver infiltration following malignancy, high SAAG ascites can occur. So liver infiltration can masquerade as cirrhosis. Malignant acanthosis and tripe palm are the paraneoplastic manifestations seen in GI malignancies. We are reporting a case which was initially managed as a straightforward case of cirrhosis ,but later turned out to be a case with tripe palms, malignant acanthosis and carcinoma stomach as primary with diffuse liver infiltration having high SAAG ascites.
ABSTRACT
Florid cutaneous papillomatosis(FCP) is a disease consisting of multiple acuminate keratotic papules in association with an underlying malignancy. Most common underlying malignancy is gastric adenocarcinoma. Other associated malignancies are breast cancer, bladder cancer, hepatobiliary cancer, ovarian cancer and uterine cancer. An association of FCP with other signs of internal cancer is common, with malignant acanthosis nigricans usually appearing many times with sign of Leser-Trelat. We experienced a florid cutaneous papillomatosis associated gastric adenocarcinoma in an 84 years old woman. The patient had a severe itching and showed numerous tiny papules on the trunk(FCP) and brown verrucose papules on the axillae(acanthosis nigricans) and hyperkeratotic yellowish tiny papules on the palms(tripe palm). Histopathologically, the lesion of the trunk exhibited papillomatosis, hyperkeratosis, and acanthosis in the epidermis. Gastroscopic biopsy revealed gastric adenocarcinoma.