TABLE 1

Cancer screening workup for acanthosis nigricans with suspicious featuresa

Age-appropriate cancer screeningb

  • Mammography (ages 50–74)c

  • Cervical cancer screening (ages 21–65)c

  • Colorectal cancer screening (ages 45–75)

  • Lung cancer screening (ages 50–80, with smoking history)

Focused laboratory studies

  • Alpha-fetoprotein tumor marker (reference range 0.0–10.0 ng/mL)

  • Cancer antigen 19-9 (reference range 1.2–5 U/mL)

  • Carcinoembryonic antigen (reference range 0.0–5.0 ng/mL)

  • Lactate dehydrogenase (reference range 110–220 U/L)

Imaging/visualization

  • Colonoscopy, endoscopy

  • Renal and gallbladder ultrasonography

  • Consider computed tomography of abdomen and pelvis

  • Consider referral to gastroenterology

  • ↵a Screening for intra-abdominal adenocarcinoma in most cases, but also gastric, ovarian, endometrial, uterine/cervical, breast, liver, lung, pancreas, colorectal.

  • ↵b Based on US Preventive Services Task Force guidelines for patients at average risk. See reference 1.

  • ↵c Not performed in our male patient.