%0 Journal Article
%T Sign of Leser-Tr¨Ślat Associated with Esophageal Squamous Cell Cancer
%A Vinaya Gaduputi
%A Chaitanya Chandrala
%A Hassan Tariq
%A Kalyan Kanneganti
%J Case Reports in Oncological Medicine
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/825929
%X The sign of Leser-Tr¨Ślat is a rare paraneoplastic phenomenon marked by accelerated onset of multiple seborrheic keratoses. The occurrence of the sign often points towards underlying visceral malignancies which in a majority are adenocarcinomas of the gastrointestinal tract. We report this case of a 65-year-old man who presented with sign of Leser-Tr¨Ślat and was diagnosed with poorly differentiated squamous cell cancer of the esophagus. To our knowledge this is only the second such reported association of Leser-Tr¨Ślat sign with squamous cell cancer of esophagus. 1. Introduction The sign of Leser-Tr¨Ślat is a misnomer as both Edmund Leser and Ulysse Tr¨Ślat described skin lesions unrelated (senile angiomas) to seborrheic keratoses [1, 2]. It was Hollander that first recognized the possible association between worsening seborrheic keratoses and underlying visceral malignancies [1]. The sign of Leser-Tr¨Ślat is a rare paraneoplastic phenomenon marked by accelerated onset of multiple seborrheic keratoses. This acceleration can manifest both as increase in size and number of the skin lesions. Validity of the sign is subject to contestation [2, 3] as both visceral malignancies and seborrheic keratoses increase in incidence in parallel, with advancing age. Case control studies could not demonstrate a strong association of seborrheic keratoses with underlying visceral malignancies [3¨C5]. However, it has been noted by Schwartz [6] that there is a strong association of sign of Leser-Tr¨Ślat with malignant acanthosis nigricans, a well established paraneoplastic lesion, and therefore could itself be regarded as a paraneoplastic phenomenon. Multiple cases have been reported about rapidly growing seborrheic keratoses with various underlying malignancies, commonly including adenocarcinomas of stomach, colon, and lymphomas. 2. Case Report A 65-year-old Hispanic man presented to the clinic with complaints of progressively worsening dysphagia and unintentional weight loss of 30 pounds over the preceding 2 months. Patient reported dysphagia to both solid as well as liquid food. Patient also complained of multiple worsening (both in size and in number) dark colored skin lesions on his neck and his back. His medical comorbidities included well controlled bronchial asthma and vitamin B12 deficiency. The patient admitted to chronic heavy smoking for almost 40 years. Physical examination revealed a hemodynamically stable, cachectic man (BMI: 19.4) with multiple hyperpigmented, well-demarcated and raised lesions with Ą°stuck-onĄą appearance on both sides of the neck (Figure 1) and the
%U http://www.hindawi.com/journals/crionm/2014/825929/