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Cronkhite-Canada症候群は,遺伝性が証明されず,脱毛,爪の萎縮,色素沈着を伴う比較的稀な消化管ポリポージスで,癌の合併は少ないが,しばしば悪液質に陥って死亡するといわれている.われわれは,直腸癌を合併し,手術後緩解を示した1例を経験したので報告する.
A patient with Cronkhite-Canada's syndrome who had a complication of rectal cancer and showed remarkable improvement after operation is reported. The patient, a 51-year-old male, went to a practitioner with a complaint of bloody faces, and was found to have 4 polyps in the rectum, which were diagnosed as cancer by polypectomy. He was admitted to our hospital for radical operation. No particular matter was in the family history and anamnesis. No physical anomaly was found in the chest-abdominal part, nor was any superficial lymphnode palpable; no tumor was seen on the body surface. According to the laboratory investigation, anemia was not present; serum protein 5.9 g/dl; serum K and Ca, 3.7 and 4.2 mEq/l, respectively. Soon ofter admission, alopetia, nail atrophy and hyperpigmentation on the back of the hand appeared. X-ray and endoscopic examination revealed numerous reddish polyps half the size of a rice grain to that of azuki bean were found in the stomach and colon, but these was no polyp in the esophagus and small intestine. Rectectomy was performed as the radical operation for rectal cancer. The removed rectum showed hypertrophic rugae and numerous reddish polyps. Histologically, cystic dilatation of the glands, stromal edema, bleeding and inflammatory cell infiltration were recognized, but remaining cancer was not seen. The patient's disease was diagnosed as Cronkhite-Canada's syndrome according to the above-described clinical observations and histopathological findings. During the follow-up for about 5 months after the operation, alopetia, nail atrophy and hyperpigmentation gradually improved, and simultaneously polyposis in the digestive organ decreased in number or disappeared.
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