Intraoral Acanthosis nigricans and its clinical relevance as a manifestation of a paraneoplastic syndrome: A case report.

  • Francisca Donoso-Hofer Faculty of Dentistry, University of Chile, Santiago, Chile. Maxillofacial surgery Department, San Juan de Dios Hospital, Santiago, Chile.
  • Jaime de la Maza-Acevedo Faculty of Dentistry, University of Chile, Santiago, Chile.


Malignant-or-paraneoplastic acanthosis nigricans is a verrucous and hyperpigmented tumor affecting the mucosa and skin. In most cases malignant acanthosis nigricans is a distant manifestation of an intra-abdominal primary cancer. While the diagnosis of malignant acanthosis nigricans is challenging, some specific clinical and histopathological findings could lead to an accurate diagnosis. A rare clinical case of a 59-year-old female, who was referred to the maxillofacial surgery service due to a painful oral lesion in the palatine region, is presented. Upon examination, papillomatous lesions were observed on the hard palate, that were later diagnosed as intraoral malignant acanthosis nigricans secondary to gastric cancer. Both local and systemic evaluations are discussed, highlighting the relevance of a multidisciplinary approach consistent with the fact that these manifestations, although infrequent, should generate suspicion among clinicians and therefore motivation to perform a diligent and complete study since it can reveal the presence of a malignant pathology.


1. Popa ML, Popa AC, Tanase C, Gheorghisan-Galateanu AA. Acanthosis Nigricans: To be or not to be afraid. Oncol Lett. 2019;17(5):4133-8.
2. Soto-Ortiz JA, Amezcua-Rosas G, Guardado-Luevanos I, Bologna-Molina R. Acantosis nigricans. Manifestaciones bucales. Dermatol Rev Mex. 2011;55(1):47-50.
3. Martin de Vidales Hernandez MC, Mayor Arenal M, Gonzalez-Beato Merino MJ. Acantosis nigricans. A propósito de un caso. FMC. 2005;12(1):32-5.
4. Yu Q, Li XL, Ji G, Wang Y, Gong Y, Xu H, Shi YL. Malignant acanthosis nigricans: an early diagnostic clue for gastric adenocarcinoma. World J Surg Oncol. 2017; 15(1):208.
5. Brown TM, Krishnamurthy K. Histology, Dermis. StatPearls. Treasure Island (FL): StatPearls Publishing; 2019.
6. Rodriguez L, Yurgaky J, Otero W, Faizal M. A Review of paraneoplastic syndromes in gastrointestinal tumors. Rev Colomb Gastroenterol. 2017;32(3)226-40.
7. Ramirez-Amador V, Esquivel-Pedraza L, Caballero-Mendoza E, Berumen-Campos J, Orozco-Topete R, Angeles-Angeles A. Oral manifestations as a hall-mark of malignant acanthosis nigricans. J Oral Pathol Med. 1999;28(6):278-81
8. Phiske MM. An approach to acanthosis nigricans. Indian Dermatol Online J. 2014;5(3):239-49
9. Hejna M, Wöll E, Tschandl P, Raderer M. Cutaneous paraneoplastic disorders in stomach cancer: Collaboration between oncologically active dermatologists and clinical oncologists. Crit Rev Oncol Hematol. 2016;103:78-85.
10. Kutlubay Z, Engin B, Bairamov O, Tuzun Y. Acanthosis nigricans: A fold (intertriginous) dermatosis. Clinics in Dermatology. 2015;33(4):466-70.
11. De Schepper S, Naeyaert JM. Acanthosis nigricans. Encyclopédie medico-chirurgicale. Elsevier. 2006: 98-670.
12. Lee HC, Ker KJ, Chong W. Oral Malignant Acanthosis Nigricans and Tripe Palms Associated With Renal Urothelial Carcinoma. JAMA Dermatol. 2015;151(12):1381-3.
13. Sedano HO, Gorlin RJ. Acanthosis nigricans. Oral Surg Oral Med Oral Pathol 1987;63:462-7
14. Arana JC, Corona A. Cáncer gástrico. Rev Fac Med UNAM. 2004;47(5)204-9
15. Cannavo SP, Guarneri C, Borgia F, Guarneri B. Confluent and reticulated papillomatosis and acanthosis nigricans in an obese girl: two distinct pathologies with a common pathogenetic pathway or a unique entity dependent on insulin resistance? J Eur Acad Dermatol Venereol. 2006;20:478-80.
16. Schadt CR. The cutaneous manifestations of gastro-intestinal malignancy. Semin Oncol. 2016;43(3):341-6.
17. Koyama S, Ikeda K, Sato M, Shibahara K, Yuhara K, Fukutomi H, Fukunaga K, Kanazawa N, Yuzawa K, Fukao K, Iijima T, Kikuchi M, Tomiya T, Fujiwara K. Transforming growth factor-alpha (TGF-alfa) producing gastric carcinoma with acanthosis nigricans: an endocrine effect of TGF-alfa in the pathogenesis of cutaneus paraneoplastic syndrome and epithelial hyperplasia of the oesophagus. J Gastroenterol. 1997;32(1):71-7.
18. Karakas Y, Esin E, Lacin S, Ceyhan K, Heper AO, Yalcin S. A case of acanthosis nigricans as a paraneoplastic syndrome with squamous cell lung cancer. Onco Targets Ther. 2016;9:4815-20.
19. Deen J, Moloney T, Burdon-Jones D. Severe, Malignant Acanthosis Nigricans Associated with Adenocarcinoma of the Endometrium in a Young Obese Female. Case Rep Dermatol. 2017;9(1):30-7.
How to Cite
DONOSO-HOFER, Francisca; DE LA MAZA-ACEVEDO, Jaime. Intraoral Acanthosis nigricans and its clinical relevance as a manifestation of a paraneoplastic syndrome: A case report.. Journal of Oral Research, [S.l.], v. 8, n. 3, p. 249-253, aug. 2019. ISSN 0719-2479. Available at: <>. Date accessed: 24 july 2021. doi: