BACKGROUND: The malignant form of @entity14593 (K  hlmeier- @entity14593 ) is a rare @entity432 that can affect multiple organ systems. @entity1 typically present with distinctive @entity272 reflective of vascular drop out. The small bowel is the most common internal organ involved, resulting in considerable morbidity and mortality attributable to ischemic microperforations. Determination of the presence of @entity344 is critical in distinguishing systemic from the benign, cutaneous only disease and in identifying candidates for treatment. CASE PRESENTATION: We describe an 18  year old male who first presented with cutaneous @entity14593 but became critically ill from small bowel microperforations. He had an almost immediate and dramatic response to treatment. Prior to his presentation with acute abdomen he had upper and lower endoscopy showing areas of nonspecific patchy erythema. At laparotomy, innumerable characteristic lesions with central pearly hue and @entity8668 were seen. PubMed was used for a literature search using the keywords @entity14593 , @entity14593 , endoscopy, laparoscopy and laparotomy. This search yielded 200 articles which were further analyzed for diagnostic procedures and findings. Among the 200 articles we identified only 11 cases in which endoscopy was performed. Results of endoscopy and laparotomy in our @entity1 with @entity14593 were compared to those in the literature. Endoscopy of the gastrointestinal tract has shown @entity3621 and non-specific @entity32 whereas laparoscopy shows white plaques with red borders on the serosal surface of the small bowel and the peritoneum. From personal communications with other physicians worldwide, we identified three additional unpublished cases in which endoscopy revealed only minimal changes while laparoscopy showed @entity75 . From our experience the endoscopic findings are often subtle and nonspecific, whereas laparascopy or laparotomy will reveal pathognomic lesions on the serosal surface of the intestine. CONCLUSION: Our report contrasts the endoscopic and laparoscopic findings in @entity14593 which suggest laparoscopy is the more powerful means of detecting @entity344 . Imaging studies may serve as a key indicator of systemic progression. Based on our experience, laparoscopy should be performed when there is a high index of suspicion for gastrointestinal @entity14593 , even if endoscopic examination is non-diagnostic or normal.

Laparoscopy shows superiority over endoscopy for early detection of malignant XXXX : a case report and review of literature.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patient'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity8668 :: ('MESH:D001882', 'Disease') :: ['erythematous border'] @entity75 :: ('MESH:D001927', 'Disease') :: ['dramatic lesions'] @entity344 :: ('MESH:D005767', 'Disease') :: ['gastrointestinal involvement', 'gastrointestinal lesions'] @entity14593 :: ('MESH:D054853', 'Disease') :: ['atrophic papulosis', 'malignant atrophic papulosis', 'Degos disease'] @entity3621 :: ('MESH:D005756', 'Disease') :: ['gastritis'] @entity272 :: ('MESH:D012871', 'Disease') :: ['skin lesions'] @entity432 :: ('MESH:D001157', 'Disease') :: ['thrombo-occlusive vasculopathy']
@entity344 :: (MESH:D005767,Disease) :: ['atrophic papulosis gastrointestinal complications']
