Elsevier

The Lancet Oncology

Volume 5, Issue 9, September 2004, Page 549
The Lancet Oncology

Clinical Picture
Digital gangrene and Raynaud's phenomenon as complications of lung adenocarcinoma

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    The frequent association with AC could be related to the mucus producing and its capacity to induce aPL [73]. Twelve single case reports were dedicated to this category [6,28,74–83]. Clinical features were classical Raynaud phenomenon described as classical discolored finger (initially white or blue then red) with discomfort, worsened in nine of the cases by reaching painful digital necrosis and not triggered by cold exposure.

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    This finding has recently been corroborated in a European population.62 The Raynaud phenomenon, a common manifestation of scleroderma, can also be an isolated manifestation of occult malignancy and, in some cases, the presenting manifestation.63–65 The Raynaud phenomenon together with panniculitis has also been described as a cutaneous manifestation of myeloma.66

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    The episodic ischemia is characterized by a three-phasic color change of digital tips (pallor, cyanosis, and hyperemia). Unlike CLV, paraneoplastic Raynaud's is not associated with lymphoproliferative disorders but seems to be associated with metastatic solid tumors such as breast,71 ovarian,72 lung,73 head and neck,74 hepatocellular,75 and colorectal76 carcinomas. Raynaud's as a neoplastic phenomenon was first reported in 1884 in a middle-aged female with breast cancer metastatic to her cervical sympathetic trunk,77 leading to overstimulation of the sympathetic trunk, much like what is seen with connective tissues diseases.

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