Three simultaneous paraneoplastic skin manifestations in a patient with renal angiosarcoma

Anti-Amphiphysin-associated limbic encephalitis in a 72-year-old patient with aortic angiosarcoma

Paraneoplastic autoimmune encephalopathic syndromes have been described most often in association with small cell lung cancer or breast cancer, tumours of the ovaries, testes, lymphoma and thymoma. Antibodies associated with paraneoplastic encephalopathies are, among others, anti-Hu, anti-Ma2 and, in part, anti-N-methyl-D-aspartate(NMDA)-receptor antibodies. Here, we present the case of a 72-year-old patient hospitalised due to progressive cognitive decline and disorientation. Diagnostic workup revealed paraneoplastic anti-amphiphysin associated limbic encephalitis on the basis of an aortic angiosarcoma with metastases to kidney, muscle and bones. Highly aggressive chemotherapy as well as immunosuppressive therapy and cytoreductive laparoscopic nephrectomy were initiated. However, follow-up revealed further tumour progress and a worsening of neurological symptoms.

Eruptive inflamed seborrheic keratoses in the setting of endometrial adenocarcinoma

Eruptive seborrheic keratoses have been reported as a rare paraneoplastic dermatosis in the setting of internal malignancy, particularly that of the digestive tract. This case illustrates a patient with a family history of gastric cancer who presented with an acute eruption of inflamed pruritic seborrheic keratoses with annular and gyrate erythema, and was found to have endometrial adenocarcinoma. The inflammatory cutaneous eruption resolved shortly after surgical removal of the dysplastic uterine tissue. This case demonstrates an example of a common gynecological malignancy presenting in an uncommon way; in the absence of uterine bleeding, the patient’s skin manifestations in the form of a paraneoplastic dermatosis prompted timely diagnosis. Thus this case serves to raise awareness of cutaneous manifestations of a women’s health issue, in which early detection can impact health outcomes.