Multiple primary cancer in Leser — Trelat syndrome (description of a clinical case)

Abstract

The article provides information about one of the typical paraneoplastic syndromes — Leser — Trelat syndrome, a condition that develops jointly and sometimes precedes the appearance of a malignant visceral tumor. Brief clinical characteristics of Leser — Trelat syndrome are presented. Its predominant development in elderly and senile patients has been outlined, as well as its predominant association with malignant neoplasms of the gastrointestinal tract (47.7 %), lungs, mammary glands, prostate, kidneys, liver, T‑cell lymphomas (fungal mycosis, Sesari syndrome). Possible atypical relationships of Leser — Trelat syndrome with basalioma of the lower eyelid, skin melanoma are disclosed. Cases of fast (several months) and slow (years) formation of this paraneoplastic syndrome with a typical widespread nature of the lesion and a rare focal localization of keratomas are described. A clinical case with typical manifestations of dermatological paraneoplastic syndrome in the form of Leser — Trelat syndrome in a patient with multiple primary metachronous cancer is presented: right breast cancer (T2N0M0; ER‑, PR‑, HER2neu‑; 2017), right kidney cancer (T1N0M0; 24.02.2020), cancer of the rectum and sigmoid colon (T4N0M0; 22.07.2020). Pathological signs of malignant transformation of female genitals, peripheral lymph nodes were not found. Combined treatment (surgical intervention: resection of right kidney, combined resection of sigmoid colon, extirpation of uterus with appendages, polypectomy of colon in combination with a course of chemotherapy in a neoadjuvant mode) facilitated the resolution of seborrheic adenomas, which confirmed the paraneoplastic nature of Leser — Trelat syndrome.