Gastric Cancer Case with Skin Metastases and Scleroderma-like Paraneoplastic Rheumatic Syndrome

In this case report, we will describe a gastric cancer case, which presented with rare manifestation of skin metastases and unrelated to the mechanical impact of distant metastases scleroderma-like paraneoplastic rheumatic syndrome. 72-year-old woman was referred to hospital with complaints gradual during the time period of one year. Skin changes included - thickening, dermal induration mostly seen on her upper body – arms, neck, face, chest and abdominal wall, causing contracture and limited movements. In the area of her upper arms, neck and upper part of her chest multiple small, painless, hard subcutaneous nodules were present and hyperpigmentation in the neck area. There were no signs of Raynaud’s phenomenon, telangiectasia, alopecia, hypopigmentation or muscle weakness and pain. Upon further examination and multiple biopsies (gastric and skin nodules) poorly differentiated gastric carcinoma was confirmed with peritoneal dissemination, ascites, cutaneous, subcutaneous metastasis and scleroderma-like paraneoplastic syndrome. After systemic treatment for gastric cancer patient showed improvement of paraneoplastic syndrome manifestations, quality of life and radiologically stable disease.