早期癌を合併した胃限局性若年性ポリポーシスの1例

Juvenile Gastric Polyposis Accompanied by Gastric carcinoma, Report of a Case

要旨　患者は54歳，女性．50歳時に前庭部の胃ポリポーシスを指摘され他院で胃亜全摘術を受けた．4年後に鉄欠乏性貧血，低蛋白血症が出現し，残胃に多発性のポリープの再発を認めた．胃以外の消化管にはポリープは認められず，また，家族歴にも特記事項はなかった．残胃全摘術を施行し，病理学的に検討した結果，若年性ポリポーシスの一部粘膜内に高分化腺癌の合併を認めた．本症例のように若年性ポリポーシスが胃に限局してみられることは極めてまれであり，癌化の問題を含め本疾患の特徴について文献的考察を行った．

　A 54-year-old female patient was admitted to our hospital. She had undergone partial gastrectomy for gastric polyposis in 1993. Four years after the first operation, newly developing polyps were detected by upper gastrointestinal series and gastric endoscopic examination. Laboratory data showed iron deficiency anemia and hypoproteinemia due to protein-losing gastropathy. She underwent total gastrectomy. Histological examination of the resected stomach revealed characteristic features of juvenile polyposis, and a well-differentiated adenocarcinoma was found at the anal side of the polyps.