直腸癌を伴つたBowen病の1例

BOWEN'S DISEASE WITH RECTUM CARCINOMA

I．緒言

　1959年Graham　＆　Helwig^1）はBowen病と内臓悪性腫瘍との合併についてその因果関係を論じ，以来この両者の関係が注目されるようになつた。本邦においては，上野ら^2）によると170例中6例に内臓癌の合併があり，その後さらに2例の報告が^3）されている。この8例の内訳は子宮癌4例，胃癌3例，直腸癌1例である。合併内臓癌は，数年遅れて発症することが多いとされている^4）。最近経験した直腸癌を伴つたBowen病の1例を報告すると共に，Bowen病と合併する癌臓器について本学病理学教室^5）における剖検悪性腫瘍755例の統計的観察を参考にして考察してみたい。

A 81-year-old man found an itchy, 1.5×4.5cm-sized erythema on the extensor aspect of lower part of the right thigh five years ago.

On examination, there was a red, flatly elevated, 2.5×5.0cm in size, sharply marginated patch 5cm above the patella, the center of which was slightly depressed. It was proved to be Bowen's disease histologically.

He had also 2 dark brown, rice-sized, verrucous papules and several senile warts on the left preauricular region. Histologic specimen from the former showed Bowenoid structure of superficial basal cell epithelioma.

He has had bloody feces for 3 months, and adenocarcinoma of the rectum was found by rectoscopy and histopathological study.

From the statistical studies on 755 autopsied cases of malignant neoplasma in the Department of Pathology of Tokyo Medical and Dental University, the author came to the conclusion that coexistence of Bowen's disease and internal malignancy is nothing but an accidental concurrence, although causal relation between Bowen's disease and internal malignancy has been discussed by many researchers since Graham & Helwig.