Vater乳頭部癌，S状結腸癌を伴った家族性大腸腺腫症（Gardner症候群）の1例

Early Periampullary Carcinoma and Advanced Sigmoid Colon Cancer Associated with Familial Adenomatous Polyposis (Gardner's Syndrome), Report of a Case

要旨　患者は40歳，女性で，便秘・食欲低下・腹部腫瘤を主訴に精査を受け，Vater乳頭部腺腫内癌，十二指腸ポリポーシス，S状結腸進行癌を伴った家族性大腸腺腫症（Gardner症候群）であることが判明し，乳頭部腫瘤局所切除，S状結腸切除術および両側卵巣摘除術が施行された．異父兄が異時性に直腸癌と傍乳頭部進行癌を伴ったGardner症候群であり，傍乳頭部癌の家系内集積性を示唆していた．本例は傍乳頭部病変の診断と治療を考えるうえで興味ある症例と考えられた．

　A 40-year-old woman complained of constipation, anorexia and abdominal tumour, and was diagnosed as having an early periampullary carcinoma and advanced sigmoid colon cancer associated with familial adenomatous polyposis (Gardner's syndrome). Local excision of the periampullary tumour and sigmoidectomy were performed. The patient's elder brother had also suffered from metachronous rectal cancer and advanced periampullary carcinoma associated with this syndrome, suggesting the possible familial segregation of periampullary neoplasia. Endoscopic close surveillance of the periampullary region is mandatory for early detection and less invasive treatment of periampullary neoplasms.