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Case Reports
. 2020 Sep 26;8(18):4122-4127.
doi: 10.12998/wjcc.v8.i18.4122.

Sweet syndrome as a paraneoplastic manifestation of cholangiocarcinoma: A case report

Camille Carneiro Lemaire  1 , Ana Luisa Carvalho Portilho  1 , Luciana V Pinheiro  2 , Rafael Alves Vivas  3 , Maíra Britto  4 , Melaine Montenegro  2 , Luiz Felipe de Farias Rodrigues  5 , Sérgio Arruda  6 , André Castro Lyra  7 , Lourianne Nascimento Cavalcante  8
Affiliations
Case Reports

Sweet syndrome as a paraneoplastic manifestation of cholangiocarcinoma: A case report

Camille Carneiro Lemaire et al. World J Clin Cases. .

Abstract

Background: Sweet's syndrome, also known as acute febrile neutrophilic dermatosis, is a rare skin disorder that may be associated with cancer.

Case summary: A 58-year-old female presented with a cholestatic syndrome and significant weight loss three months before admission. Five months earlier, she had abruptly developed skin lesions with erythematous papules that evolved to erythematous blisters. Clinical evaluation and laboratory tests confirmed hepatic cholangiocarcinoma. Skin lesions histopathological findings showed neutrophilic dermatosis, massive edema, fibrin, necrosis, and elastosis. These results, in association with the macroscopic aspects of the findings, led to the diagnosis of paraneoplastic Sweet's syndrome due to cholangiocarcinoma. As staging was consistent with an advanced tumor without a cure perspective, we opted to perform percutaneous biliary drainage, and subsequently, palliative care. Eventually, after a few weeks, the patient died.

Conclusion: In conclusion, the diagnosis of the underlying disease-causing Sweet's syndrome must be accurate, and patients need to be followed-up, as neoplasia such as cholangiocarcinoma may be a later manifestation.

Keywords: Bullous lesions; Case report; Cholangiocarcinoma; Cholestasis; Paraneoplastic syndrome; Sweet syndrome.

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Conflict of interest statement

Conflict-of-interest statement: All authors worked on this case and none of them have conflict of interest.

Figures

Figure 1
Figure 1
Blistering skin lesions suggesting pemphigus on foot (A) and hands (B).
Figure 2
Figure 2
Axial plane image of computed tomography obtained in the portal phase showing significant intrahepatic biliary tract dilatation (orange arrows).
Figure 3
Figure 3
Axial plane image of computed tomography obtained in the portal phase showing an infiltrative aspect of the tumor, with irregular contour and mild contrast enhancement located at the common bile duct (orange arrows) determining biliary tract dilatation.
Figure 4
Figure 4
Skin lesions biopsy stained with hematoxylin-eosin showed elastosis (yellow arrow), edema (orange arrow), bleeding focus and red cells extravasation (black arrows) (A) and capillary destruction (B).
Figure 5
Figure 5
Timeline of events reported in the clinical case.
See this image and copyright information in PMC

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