A 60-year-old woman visited our hospital, complaining of hyperpigmentation and itching of the skin. The case was histologically diagnosed as acanthosis nigricans by skin biopsies. It is usually associated with malignancies, of which gastric cancer is by far the most common. Upper endoscopy revealed advanced gastric cancer (Borrmann type 3). Total gastrectomy was performed, but the patient died of peritonitis carcinomatosa 21 months after resection. It is important to examine the upper GI tract periodically when acanthosis nigricans is present from the early stage.
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