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Old 08-15-2011
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Skin Diabetic Skin Lesion and Malignancy Risk!

A 52-year-old obese female with a history of diabetes mellitus type II presents to your office, complaining of a brown hyperpigmentation on the posterior aspect of her neck. A biopsy of the area shows epidermal thickening. Which of the following malignancies is she not at risk for?

A. Stomach
B. Breast
C. Colon
D. Uterus
E. Lung
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  #2  
Old 08-15-2011
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not at risk for?
E. lung
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Old 08-15-2011
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it seems to be D
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  #4  
Old 08-15-2011
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i think the stem is asking for malignant melanoma and ans seems like uterus! D!
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  #5  
Old 08-15-2011
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Default It is Acanthosis nigricans

ans)E Lung


A. Stomach (gastrointestinal malignancy,particulary ca.stomach-->Ancathosis nigricans)
B. Breast (obesityObesity---> inceased estorgen(aromatase) ---> ER+ ca.breast)
C. Colon(gastrointestinal malignancy,-->Ancathosis nigricans)
D. Uterus(Obesity---> increased estorgen(aromatase) ---> Ca.endometrium)

Last edited by drgsarunprasath; 08-15-2011 at 07:16 AM.
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  #6  
Old 08-15-2011
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Default No it carries risk for Ca.uterus

Quote:
Originally Posted by yasirsattar75 View Post
it seems to be D

Obesity---> inceased estorgen(aromatase) ---> Ca.endometrium
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  #7  
Old 08-15-2011
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Listening

Quote:
Originally Posted by drgsarunprasath View Post
Obesity---> inceased estorgen(aromatase) ---> Ca.endometrium
if this is the reason then how is obesity related to stomach ca? please explain.. by ur reason.. obesity can cause ca in breast, endometrium!
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Old 08-15-2011
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Default I want you to check about acnathosis nigricans

Quote:
Originally Posted by salz View Post
if this is the reason then how is obesity related to stomach ca? please explain.. by ur reason.. obesity can cause ca in breast, endometrium!

Insulin resistant and gastroinstetinal maligancy patients are prone to have this condition.
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  #9  
Old 08-15-2011
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Default Where is the hint about malignant melanoma here?

Quote:
Originally Posted by salz View Post
i think the stem is asking for malignant melanoma and ans seems like uterus! D!



Classic malignant melanoma history goes like this a black mole increasing in size rapidly or a apperance of new mole and things like that..


What makes u thin malignant melanoma here?
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Old 08-15-2011
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Quote:
Originally Posted by drgsarunprasath View Post
Obesity---> inceased estorgen(aromatase) ---> Ca.endometrium
anyways increased estrogen has nothing to do with pigmentation .. :P
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it is option D
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Post E

E. Lung

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  #13  
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Default Pigmentation is not the question about

Quote:
Originally Posted by yasirsattar75 View Post
anyways increased estrogen has nothing to do with pigmentation .. :P

It certainly has something to do with Ca.endometrium


Obesity-->insulin resistance-->acanthosis-->pigmentation

Obesity has certainlky to do with both..
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  #14  
Old 08-15-2011
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Has Acanthosis Nigricans.I am going with lung.
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Old 08-15-2011
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E.lung Ca---mostly
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Old 08-15-2011
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E). lung cancer
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  #17  
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thnaks for question but im still confused with the answer as lung cancer also causes acanthosis nigricans as its written in first aid dntknw detail n 2nd thing why is she at risk of ca stomach n colon n not of ca lung?? please someone help me in this
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  #18  
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Default ans:

Quote:
Originally Posted by ricko335 View Post
A 52-year-old obese female with a history of diabetes mellitus type II presents to your office, complaining of a brown hyperpigmentation on the posterior aspect of her neck. A biopsy of the area shows epidermal thickening. Which of the following malignancies is she not at risk for?

A. Stomach
B. Breast
C. Colon
D. Uterus
E. Lung
ans: E
EXP: PARANEOPLASTIC SYNDROME (LUNG)
ACANTHOSIS NIGRICANS associated with obesity,hyperinsulinism,MEN 11b,PCOs,neurofibromatosis,x-syundrome. and rarely asociated with stomach and other GI melignancy.....
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Old 08-15-2011
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Quote:
Originally Posted by drgsarunprasath View Post
It certainly has something to do with Ca.endometrium


Obesity-->insulin resistance-->acanthosis-->pigmentation

Obesity has certainlky to do with both..
sorry i took it different now i understand .. thanxx and now i have seen this is type 2 diabetes ..if it was type 1 then lung cannnot b answer coz mucor and rhizopus can infect lungs of type 1 diabetes with ketoacidosis ... and yup u are right about obesity increased estrogen increased chances of uterine cancer..due to imbalance between estrogen and progesterone and uterine hyperplasia at initial stage then progress to carcinoma..
so answer is lung hope so ..
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  #20  
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Default Sorry Again

Quote:
Originally Posted by yasirsattar75 View Post
sorry i took it different now i understand .. thanxx and now i have seen this is type 2 diabetes ..if it was type 1 then lung cannnot b answer coz mucor and rhizopus can infect lungs of type 1 diabetes with ketoacidosis ... and yup u are right about obesity increased estrogen increased chances of uterine cancer..due to imbalance between estrogen and progesterone and uterine hyperplasia at initial stage then progress to carcinoma..
so answer is lung hope so ..


Mucor and Rhizopus is seen in Upper respiratory tract and Sinus in DKA patient

and not in Lung.I wonder Mucor and Rhizopus can reach Lung ? If so someone plz throw some light on that...

thanks in advance

Last edited by drgsarunprasath; 08-15-2011 at 11:31 AM.
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  #21  
Old 08-15-2011
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Quote:
Originally Posted by drgsarunprasath View Post
Mucor and Rhizopus is seen in Upper respiratory tract and Sinus in DKA patient

and not in Lung.I wonder Mucor and Rhizopus can reach Lung ? If so someone plz throw some light on that...

thanks in advance
i think they can cause pnemonia in DKA along with sinusitis but not sure
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  #22  
Old 08-15-2011
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Default http://en.wikipedia.org/wiki/Acanthosis_nigricans#Endocrine

Quote:
Originally Posted by Learner View Post
thnaks for question but im still confused with the answer as lung cancer also causes acanthosis nigricans as its written in first aid dntknw detail n 2nd thing why is she at risk of ca stomach n colon n not of ca lung?? please someone help me in this


In the context of a malignant disease, acanthosis nigricans is a paraneoplastic syndrome and is then commonly referred to as acanthosis nigricans maligna. Involvement of mucous membranes is rare and suggests a coexisting malignant condition.[3]
When seen in individuals older than age 40, this disorder is commonly associated with an internal malignancy, usually adenocarcinoma, and most commonly of the GI tract or uterus; less commonly of the lung, prostate, breast, or ovary. The stomach is the most common site.[4] Acanthosis nigricans of the oral mucosa or tongue is highly suggestive of a neoplasm, especially of the GI tract.


Being a Woman of that age favours Ca.Breast,So lung would be the better option...
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  #23  
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Quote:
Originally Posted by riya_rai84 View Post
ans: E
EXP: PARANEOPLASTIC SYNDROME (LUNG)
ACANTHOSIS NIGRICANS associated with obesity,hyperinsulinism,MEN 11b,PCOs,neurofibromatosis,x-syundrome. and rarely asociated with stomach and other GI melignancy.....
u can put it as a person with diabetes mellitus type 2 is at risk of which of the followong malignancies and omit d option which is asked to be excluded
keep it simple dont digg too deep

the answer is colon

The correct answer is C.
The patient has acanthosis nigricans, which presents as a brown to black, poorly defined, velvety hyperpigmentation seen in patients with diabetes mellitus type II. These patients are at risk for the following visceral malignancies: stomach, lung, breast and uterus
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  #24  
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read d question well which of the cancer she is not at risk for in a patient with type 2 dm
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  #25  
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Default I thought adenocarcinoma of colon is a cause for acanthosis

Quote:
Originally Posted by ricko335 View Post
u can put it as a person with diabetes mellitus type 2 is at risk of which of the followong malignancies and omit d option which is asked to be excluded
keep it simple dont digg too deep


the answer is colon

The correct answer is C.
The patient has acanthosis nigricans, which presents as a brown to black, poorly defined, velvety hyperpigmentation seen in patients with diabetes mellitus type II. These patients are at risk for the following visceral malignancies: stomach, lung, breast and uterus





http://en.wikipedia.org/wiki/Acantho...cans#Endocrine
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Default

Quote:
Originally Posted by drgsarunprasath View Post
dude dont read wiki
half d stuff is crap read authentic textbooks
u use wiki 2 hv a idea not to gain knowledge
there r no reviewers 4 wiki
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  #27  
Old 08-16-2011
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Quote:
Originally Posted by drgsarunprasath View Post
Classic malignant melanoma history goes like this a black mole increasing in size rapidly or a apperance of new mole and things like that..


What makes u thin malignant melanoma here?

yup right, i read the questions again and its brown in color not black. thanks!
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  #28  
Old 08-17-2011
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Default table

Syndromes Associated With Acanthosis NigricansMalignant Diseases Associated With Acanthosis NigricansAcromegalyBile duct cancerAlstrom telangiectasiaBladder cancerBarter syndromeBreast cancerBeare-Stevenson syndromeColon cancerBenign encephalopathyEndometrial cancerBloom syndromeEsophageal cancerCapozucca syndromeGallbladder cancerChondrodystrophy with dwarfismHodgkin diseaseCostello syndromeKidney cancerCrouzon syndromeLiver cancerDermatomyositisLung cancerFamilial pineal body hypertrophyMycosis fungoidesGigantismNon-Hodgkin lymphomaHashimoto thyroiditisOvarian cancerHirschowitz syndromePancreatic cancerLawrence-Moon-Bardet syndromePheochromocytomaLawrence-Seip syndromeProstate cancerLipoatrophic diabetes mellitusRectal cancerLupoid hepatitisTesticular cancerLupus erythematosusThyroid cancerPhenylketonuriaWilms tumorPituitary hypogonadism
Pseudoacromegaly
Prader-Willi syndrome
Pyramidal tract degeneration
Rud syndrome
Scleroderma
Stein-Leventhal syndrome
Type A syndrome (HAIR-AN syndrome)
Werner syndrome
Wilson syndrome


sorry this was supposed to appear as a table, now its all messed up, anyway you may go to eMedicine.com for the table on acanthosis nigricans and its associations

Last edited by nativedoc; 08-17-2011 at 09:32 PM.
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  #29  
Old 08-21-2011
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Default Flawed

ricko,this question is inheretally flawed, because we are only assuming that her risk for cancer comes from the acanthosis nigricans. Obese patients are in greater risk for colon cancer,and all the other malignancies can be attributed to either her obesity or the presence of acanthosis nigricans. Could u please give us the source of the question if u have one?
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  #30  
Old 08-21-2011
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Quote:
Originally Posted by IstariRadagast View Post
ricko,this question is inheretally flawed, because we are only assuming that her risk for cancer comes from the acanthosis nigricans. Obese patients are in greater risk for colon cancer,and all the other malignancies can be attributed to either her obesity or the presence of acanthosis nigricans. Could u please give us the source of the question if u have one?
its mentioned in first aid malignancy associated with acanthosis nigricans .. just chill dont b tense
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  #31  
Old 08-22-2011
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ACANTHOSIS NIGRICANS .. SKIN COLOUR CHANGES ..IN DIABETES AND VISCERAL
MALIGNENCY e.g stomach cancer
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  #32  
Old 09-10-2011
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Warning!

Quote:
Originally Posted by drgsarunprasath View Post

Malignant acanthosis nigricans is rarely associated with carcinoma of the bowel or cervix.
http://www.ncbi.nlm.nih.gov/pubmed/177146
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