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Leser-Trélat Sign

  • Eric M. Neverman and Kevin Clary
Published/Copyright: July 1, 2014
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 114 Issue 7

A 64-year-old man presented to the emergency department with a 1-day history of hematochezia and a 3-month history of melena, during which time he experienced a 20-lb weight loss. Physical examination revealed confluent seborrheic keratoses on the patient's chest (image). Results of laboratory tests indicated microcytic anemia, with a hemoglobin level of 9.4 g/dL and a mean corpuscular volume of 78.4 μm3. Colonoscopy revealed 2 ulcerated masses within the sigmoid colon; the scope could not be advanced past the proximal lesion. Histopathologic evaluation of biopsy specimens showed ulcerated, moderately differentiated adenocarcinoma. The patient underwent resection of the segment of the colon with the masses and continued to receive surgical oncologic treatment.

An eruption of seborrheic keratoses occurring with a malignant tumor, particularly gastrointestinal adenocarcinoma, is consistent with Leser-Trélat sign.1 Some researchers have disputed the association of seborrheic keratoses with malignant tumors because both findings occur frequently in older individuals.2 However, reports 3-5 of Leser-Trélat sign in young individuals suggest that seborrheic keratoses may indicate underlying malignant findings.

From the Internal Medicine-Pediatrics Residency Program at the University of Missouri School of Medicine in Columbia
Address correspondence to Eric M. Neverman, DO, MHA, Internal Medicine-Pediatrics Residency Program, University of Missouri, 1 Hospital Dr, DC058.00, Columbia, MO 65201-5276. E-mail:

Acknowledgment

We acknowledge Caryn Scoville of the J. Otto Lottes Health Sciences Library at the University of Missouri for her research assistance.

  1. Financial Disclosures: None reported

  2. Support: None reported.

References

1 Constantinou C Dancea H Meade P . The sign of Leser-Trelat in colorectal adenocarcinoma. Am Surg.2010;76(3):340-341.10.1177/000313481007600323Search in Google Scholar

2 Fink AM Filz D Krajnik G Jurecka W Ludwig H Steiner A . Seborrhoeic keratoses in patients with internal malignancies: a case-control study with prospective accrual of patients[published online March 4, 2009]. J Eur Acad Dermatol Venereol.2009;23(11):1316-1319. doi:10.1111/j.1468-3083.2009.03163.x.10.1111/j.1468-3083.2009.03163.xSearch in Google Scholar PubMed

3 Fasoldt JJ Brumwell EP Lackey JN . Leser-Trélat sign presenting in a patient with recurrent pre-B-cell acute lymphocytic leukemia. Cutis. 2012;89(1):33-35.Search in Google Scholar

4 Hamada Y Iwaki T Muratani H Imayama S Fukui M Tateishi J . Leser-Trélat sign with anaplastic ependymoma–an autopsy case. Acta Neuropathol.1997;93(1):97-100.10.1007/s004010050588Search in Google Scholar PubMed

5 Westrom DR Berger TG . The sign of Leser-Trélat in a young man. Arch Dermatol.1986;122(12):1356-1357.10.1001/archderm.1986.01660240018004Search in Google Scholar
Received: 2013-09-23
Revised: 2013-11-09
Accepted: 2013-11-19
Published Online: 2014-07-01
Published in Print: 2014-07-01

© 2014 The American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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https://doi.org/10.7556/jaoa.2014.119
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. Health Policy
  2. Impact of the Single Accreditation Agreement on GME Governance and the Physician Workforce
  3. In My View
  4. Effect of the Single Accreditation System
  5. Letters
  6. The OSTEOPATHIC Trial Demonstrates Significant Improvement in Patients With Chronic Low Back Pain as Manifested by Decreased Prescription Rescue Medication Use
  7. Response: Observational Study Demonstrates That OMT Is Associated With Reduced Analgesic Prescribing and Fewer Missed Work Days
  8. A Case of Seasonal Recurrent Myopericarditis? Tough to Say!
  9. Response
  10. AOA Communication
  11. Official Call (Reprint)
  12. Proposed Amendments to the AOA Constitution, Bylaws, and Code of Ethics (Reprint)
  13. Original Contribution
  14. Association Between Cervical and Thoracic Somatic Dysfunction Among Second-Year Osteopathic Medical Students
  15. Brief Report
  16. Mountaineering-Induced Bilateral Plantar Paresthesia
  17. Clinical Practice
  18. Management of Ionizing Radiation Injuries and Illnesses, Part 3: Radiobiology and Health Effects of Ionizing Radiation
  19. Review
  20. Primary Care Evaluation and Treatment of Men With Lower Urinary Tract Symptoms
  21. Medical Education
  22. Perception-Based Effects of Clinical Exposure to Osteopathic Manipulative Treatment on First- and Second-Year Osteopathic Medical Students
  23. Case Report
  24. Osteopathic Musculoskeletal Examination and Subarachnoid Anesthetic Administration in a Patient With Severe Scoliosis
  25. The Somatic Connection
  26. Myofascial Release Increases Effectiveness in Management of Chronic Low Back Pain
  27. Lymphatic Pump OMT Releases Cytokines Into Central Circulation
  28. Patients With Magnetic Resonance Imaging–Verified Lumbar Disk Herniations Benefit From Chiropractic High-Velocity, Low-Amplitude Spinal Manipulative Therapy
  29. Chiropractic Treatment of Pregnant Patients Supports Reduction in Low Back Pain
  30. Short-Term Effects of a Manual Therapy Protocol on Pain and Functioning in Patients With Fibromyalgia
  31. Headaches Are a Pain in the Neck
  32. Clinical Images
  33. Leser-Trélat Sign
  34. Book Reviews
  35. Osteopathic Tales
  36. The Abraham Man: Madness, Malingering, and the Development of Medical Testimony
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