Leser-Trélat Syndrome in a Male with Breast Carcinoma and Eyelid Basal Cell Carcinoma

Abstract

Purpose: Leser-Trélat syndrome consists of appearance of a solid tumor-like carcinoma breast, colon, or stomach following eruption of multiple seborrheic keratoses (SK) of the skin. We present an unusual and possibly the first case report of Leser-Trélat syndrome in a male patient with a history of mastectomy for breast carcinoma who presented to us with a second malignancy in the form of basal cell carcinoma (BCC) of the lower eyelid.

Procedure: A 75-year-old male presented in 2014 with a history of modified radical mastectomy for infiltrating ductal carcinoma of the left breast which was performed 11 years prior to the day of presentation. Breast carcinoma was diagnosed following eruption of multiple SK at the same time. In the previous 3 years he noted a nodulo-ulcerative growth over the lateral aspect of the right lower eyelid which was clinically diagnosed as BCC. Mass excision under frozen section control and lid reconstruction was performed. Diagnosis of BCC was confirmed on histopathological examination of the excised specimen.

Results and conclusions: Though a previously unobserved entity, our case supports the importance of Leser-Trélat sign and its relevance to affected individuals, as early recognition and prompt treatment of a low-stage cancer offers good prognosis.

Keywords: Basal cell carcinoma; Breast carcinoma; Eyelid malignancies; Leser-Trélat syndrome; Tenzel flap.

Fig. 1

a-d Right lower eyelid basal cell carcinoma, after lid reconstruction; seborrheic keratoses on the back and face.

Fig. 2

a-c Seborrheic keratoses on scalp biopsy, nests of subepidermal malignant basaloid cells, and characteristic peripheral palisading with mitotic figures.

Fig. 3

Comparative patient photographs demonstrating lesions on the temporal aspect of forehead prior to basal cell carcinoma excision (a) and their absence and flattening in the similar location after surgery (b).