食道びまん性ポリープを契機に発見され肺癌を合併したCowden病の1例

Cowden's Disease Associated with Lung Cancer, Report of a Case

要旨　Cowden病の経過観察中，肺癌の合併をみた症例を経験したので報告した．患者は58歳，男性．健診で食道粘膜のびまん性密在性顆粒状変化を指摘され来院．27歳時に左側胸腹部皮膚の血管腫切除の既往があった．家族歴では母が胃癌で死亡．食道粘膜全域にびまん性顆粒状隆起と胃前庭部に散在性に小隆起性病変が観察された．更に口腔粘膜に白色丘疹，右第5指に角化性丘疹，顔面にも丘疹を認めたため，Cowden病と診断した．その後，2年5か月の経過観察後に左肺上葉に腺癌が発生したため切除された．Cowden病は内臓悪性腫瘍の合併頻度が高く，注意深い経過観察が必要と思われた．

　A 58-year-old man was introduced to our hospital for evaluation of esophageal polyposis. At the age of 27, he was operated on because of hemangioma of the skin. His mother had died of gastric cancer. He was diagnosed as having Cowden's disease, because white papules in the oral cavity, keratotic papules on the right 5th finger, and normal colored papules on the face were observed. Radiologic examination of the alimentary tract revealed polyposis in the esophagus and several polyps in the stomach, but no lesions were detected in the colon. After a follow-up period of two years and five months, lung cancer (adenocarcinoma) was found in the left upper lung and he was operated on again. This is a typical case of Cowden's disease associated with malignant neoplasm of an internal organ.