Abstract
A rare case of gastric cancer with acanthosis nigricans is reported. A 50-year-old man complained of hyperpigmentation and verruca of the skin, which was histologically diagnosed as acanthosis nigricans. Examination of the upper GI tract revealed IIc-like advanced gastric cancer and a papillomatous change in the esophageal mucosa. Total gastrectomy was performed, but it was non-curative because of mutiple metastases in the para-aortic lymph nodes. Acanthosis nigricans is usually associated with malignant lesions, of which gastric cancer is by far the most common. In the past 10 years, 56 cases of malignant acanthosis nigricans have been reported in Japan. In 45 cases (80.4%) it was associated with gastric cancer, only two of which were early gastric cancer. This indicates that most patients with acanthosis nigricans have advanced gastric carcinoma probably because of ignorance of the high incidence of gastric cancer. As a result curative resection could not be performed. Therefore, it is important to investigate the upper GI tract periodically from the early stage while investigating a case of acanthosis nigricans.
