Blackish spots in abdomen, neck and face

43 yrs old female presented with complaints of abdominal discomfort, vomiting and weight loss. On general examination it was found that blackish spots in abdomen, neck and face ( acanthosis nigricans ) .

Her endoscopy revealed tumour in esophagus , biopsy suggested cancer . That's why general examination is important, these spots if noticed earlier could have led to early screening , early detection of cancer and early treatment.