TY - JOUR
T1 - Leser–Trélat syndrome in malignant mesothelioma and pulmonary adenocarcinoma
T2 - is the EGFR pathway part of the syndrome?
AU - Jepsen, Rikke Karlin
AU - Guldhammer Skov, Anne
AU - Skov, Birgit Guldhammer
PY - 2014/1
Y1 - 2014/1
N2 - The syndrome of Leser–Trélat (LT) is characterized by the sudden appearance of multiple seborrhoeic keratoses (SKs) in association with internal occult malignancy. Usually, the syndrome has been associated with adenocarcinoma, most frequently of the gastrointestinal tract and breast. The pathogenesis is unclear but might be explained by circulating tumor-associated growth factors. We present two thoracic malignancies associated with LT: adenocarcinoma of the lung (ACL) and pleural malignant mesothelioma (MM). Both malignant tumors expressed high levels of epidermal growth factor receptors (EGFR) detected by immunohistochemistry (IHC), with membranous staining on the majority of malignant cells corresponding to maximum IHC scores of 290 and 300, respectively, for the MM and the ACL. SKs revealed a universal membranous staining throughout the entire epithelium with no difference in EGFR expression between the two cases and two controls with no malignant history. By fluorescence in situ hybridization, no amplification of the EGFR gene in malignant tumors as well as in SK lesions was observed. Further investigations are needed to see whether tumor-associated EGFR ligands/EGFR autocrine loops in malignant cells expressing high levels of EGFR protein on the surface might play a role for the development of SKs, as well as for the growth of malignant tumors in LT.
AB - The syndrome of Leser–Trélat (LT) is characterized by the sudden appearance of multiple seborrhoeic keratoses (SKs) in association with internal occult malignancy. Usually, the syndrome has been associated with adenocarcinoma, most frequently of the gastrointestinal tract and breast. The pathogenesis is unclear but might be explained by circulating tumor-associated growth factors. We present two thoracic malignancies associated with LT: adenocarcinoma of the lung (ACL) and pleural malignant mesothelioma (MM). Both malignant tumors expressed high levels of epidermal growth factor receptors (EGFR) detected by immunohistochemistry (IHC), with membranous staining on the majority of malignant cells corresponding to maximum IHC scores of 290 and 300, respectively, for the MM and the ACL. SKs revealed a universal membranous staining throughout the entire epithelium with no difference in EGFR expression between the two cases and two controls with no malignant history. By fluorescence in situ hybridization, no amplification of the EGFR gene in malignant tumors as well as in SK lesions was observed. Further investigations are needed to see whether tumor-associated EGFR ligands/EGFR autocrine loops in malignant cells expressing high levels of EGFR protein on the surface might play a role for the development of SKs, as well as for the growth of malignant tumors in LT.
KW - Adenocarcinoma
KW - Aged
KW - Female
KW - Humans
KW - Keratosis, Seborrheic
KW - Lung Neoplasms
KW - Male
KW - Mesothelioma
KW - Paraneoplastic Syndromes
KW - Receptor, Epidermal Growth Factor
KW - Signal Transduction
U2 - 10.1007/s00428-013-1503-4
DO - 10.1007/s00428-013-1503-4
M3 - Journal article
C2 - 24233154
SN - 0945-6317
VL - 464
SP - 117
EP - 120
JO - Virchows Archiv : an international journal of pathology
JF - Virchows Archiv : an international journal of pathology
IS - 1
ER -