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Year : 2013  |  Volume : 58  |  Issue : 4  |  Page : 330
A 54-year-old female with skin lesions and history of renal cell carcinoma


Department of Hematology/Medical Oncology, Urmia University of Medical Sciences, Urmia, Iran

Date of Web Publication25-Jun-2013

Correspondence Address:
Nasim Valizadeh
Department of Hematology/Medical Oncology, Urmia University of Medical Sciences, Urmia
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.114005

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How to cite this article:
Valizadeh N. A 54-year-old female with skin lesions and history of renal cell carcinoma. Indian J Dermatol 2013;58:330

How to cite this URL:
Valizadeh N. A 54-year-old female with skin lesions and history of renal cell carcinoma. Indian J Dermatol [serial online] 2013 [cited 2019 Aug 21];58:330. Available from: http://www.e-ijd.org/text.asp?2013/58/4/330/114005


A 54-year-old woman was admitted with left hip joint pain and limitation of motion. She had history of left-sided radical nephrectomy for renal cell carcinoma (RCC), chromophilic type 5.5 years ago. Her father and mother were dead because of malignancies a long ago (she did not know which type). One of her children was dead with leukemia, and she had 11 healthy children. Physical examination showed skin lesions (she had them since childhood) on her back of neck [Figure 1] and both shoulders [Figure 2] and [Figure 3]. She had limitation of motion in left hip joint movements. Fasting blood sugar, complete blood count diff, blood urea nitrogen, creatinine, Na, K, aspartate transaminase, alanine transaminase, alkaline phosphatase, and albumin were reported normally. Electrocardiogram and chest X-ray were normal.
Figure 1: Fibrofolliculomas (multiple pale dome - shaped papules) on the back of her neck

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Figure 2: Acrochordon: A large pedunculated fibroma on the right shouder

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Figure 3: Acrochordons (skin tags) on the left shoulder

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Further evaluation revealed RCC with metastasis to lungs [Figure 4] in chest computed tomography scan and a large left hemipelvic mass with eroding of innominate bone, ischiopubic ramous, and partial impression of left femoral head in pelvic magnetic resonance imaging [Figure 5] suggestive of metastasis.
Figure 4: Bilateral multiple nodular metastasis in both lung fields is seen in chest computed tomography scan

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Figure 5: A large left hemipelvic mass with eroding of innominate bone, ischiopubic ramous, and partial impression of left femoral head in pelvic magnetic resonance imaging suggestive of metastasis

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   Questions Top


  1. What do you see in [Figure 1]?
  2. What do you see in [Figure 2] and [Figure 3]?
  3. Which syndrome do you consider for this patient?




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   References Top

1.Birt AR, Hogg GR, Dubé WJ. Hereditary multiple fibrofolliculomas with trichodiscomas and acrochordons. Arch Dermatol 1977;113:1674-7.  Back to cited text no. 1
    
2.Khoo SK, Bradley M, Wong FK, Hedblad MA, Nordenskjöld M, Teh BT, et al. Birt-Hogg-Dubé syndrome: Mapping of a novel hereditary neoplasia gene to chromosome 17p12-q11.2. Oncogene 2001;20:5239-42.  Back to cited text no. 2
    
3.Nickerson ML, Warren MB, Toro JR, Matrosova V, Glenn G, Turner ML, et al. Mutations in a novel gene lead to kidney tumors, lung wall defects, and benign tumors of the hair follicle in patients with the Birt-Hogg-Dubé syndrome. Cancer Cell 2002;2:157-64.  Back to cited text no. 3
    
4.Zbar B, Alvord WG, Glenn G, Turner M, Pavlovich CP, Schmidt L, et al. Risk of renal and colonic neoplasms and spontaneous pneumothorax in the Birt-Hogg-Dubé syndrome. Cancer Epidemiol Biomarkers Prev 2002;11:393-400.  Back to cited text no. 4
    
5.Adley BP, Smith ND, Nayar R, Yang XJ. Birt-Hogg-Dubé syndrome: Clinicopathologic findings and genetic alterations. Arch Pathol Lab Med 2006;130:1865-70.  Back to cited text no. 5
    
6.Roth JS, Rabinowitz AD, Benson M, Grossman ME. Bilateral renal cell carcinoma in the Birt-Hogg-Dubé syndrome. J Am Acad Dermatol 1993;29:1055-6.  Back to cited text no. 6
    
7.Pavlovich CP, Walther MM, Eyler RA, Hewitt SM, Zbar B, Linehan WM, et al. Renal tumors in the Birt-Hogg-Dubé syndrome. Am J Surg Pathol 2002;26:1542-52.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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