Juvenile Polyposis with Spontaneous Disappearance of Some of the Polyps, Report of a Case Tomoaki Suga 1 , Taiji Akamatsu 2 , Naoshi Nakamura 1 , Miho Sakaguchi 1 , Hideaki Hamano 1 1The Second Department of Internal Medicine, Shinshu University School of Medicine 2Department of Endoscopy, Shinshu University School of Medicine Keyword: 若年性ポリポーシス , 胃癌 , 蛋白漏出性胃腸症 , 自然消褪 pp.1307-1314
Published Date 2001/9/25
DOI https://doi.org/10.11477/mf.1403103328
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 A 29-year-old woman visited Shinshu University Hospital in March,1999, complaining of general fatigue and body-weight loss. She had a 10-year history of unknown multiple gastric polyps. Laboratory studies showed a slight iron deficiency anemia and hypoproteinemia. Alpha-one-antitripsin clearance test showed that the hypoproteinemia in this case was due to protein losing gastroenteropathy. Barium meal examination and upper GI endoscopy revealed multiple gastric polyps, but gastric mucosa existing among the polyps was almost normal. Barium enema and colonoscopy showed some polyps. Diagnostic endoscopic mucosal resection was performed in the stomach and colon. Microscopic findings of the resected specimens revealed edematous change of mucosa and dilatation of capillaries on the surface of the polyps, but mucosa around the polyps was almost normal. These findings led to a diagnosis of gastrointestinal juvenile polyposis. After 8 months, multiple gastric polyps and some colonic polyps spontaneously improved, and anemia and hypoproteinemia lessened. However, a polypoid lesion prolapsing into the bulbus remained, and biopsy specimens obtained from it revealed poorly differentiated adenocarcinoma. Distal gastrectomy was performed in January,2000. Pathological examination showed that papillary adenocarcinoma, and moderately and poorly differentiated adenocarcinoma were mixed in the lesion, but these carcinoma cells were limited to the mucosa.

 Gastrointestinal cancer is often complicated in patients with juvenile polyposis, but spontaneous im-provement of multiple polyps is rare. This case may be the first report of spontaneous improvement in juvenile polyposis.

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