Carcinoma of Unknown Primary Presenting as Peripheral Symmetric Gangrene

Cancer of unknown primary accounts for almost 4-5% of all invasive cancers and consists of tumors from various primary sources with considerable heterogeneity in biology and behaviour. Most of these tumors present with symptoms due to distant metastasis. Histology, immunohistochemistry and molecular profiling is the mainstay for diagnosis. In most cases of adenocarinoma associated with paraneoplastic acral vascular syndrome (PAVS), a site in the lung, ovary or uterus is discernible. Here we report a case of metastatic adenoarcinoma of unknown primary presenting as PAVS, a case which to the best of our knowledge has not been reported in published literature.