紅皮症に合併した噴門部早期胃癌の1例

Early Gastric Cancer Associated with Erythroderma, Report of a Case

　紅皮症に合併した噴門部早期胃癌の1例を経験したので報告する．

　A 65 year-old man was referred to the dermatological service at Tokyo Medical College Hospital because of erythroderma. There were no history of dysphagia, vomiting, abdominal pain or previous digestive diseases.

　Erythroderma associated with neoplasm was suggested because there was no sign of improvement in spite of corticosteroid therapy. Laboratory findings showed the increase of eosinophils but no evidence of malignant lymphoma or leukemia.

　An esophagogram and upper gastrointestinal x-ray series showed the elevated lesion on the esophagocardia junction. Endoscopic biopsy specimens taken from the lesion revealed well-differentiated tubular adenocarcinoma.

　Proximal partial gastrectomy was done and pathological examination revealed early gastric cancer type-I with no lymph nodes metastasis, which was well-differentiated tubular adenocarcinoma histologically, and limited to the mucosa and submucosal layer. After operation, erythroderma improved temporarily but resulting in exacerbation, and he died on the 60th day after operaion.

　It is a question whether or not in our case erythroderma is dermadrome of early gastric cancer, because he had a history of eczema and contact with agricultural chemicals.

　This case is the first report of early gastric cancer associated with erythroderma. But, a few other internal neoplasms, for example, uterus cancer, lung cancer and hepatoma associated with erythroderma are also reported, which means that one must consider its association with the internal neoplasm in addition to cutaneous T-cell lymphoma and blood neoplasm in all cases of erythroderma.