大腸ポリープ症に随伴病変を伴った母子例

Two Cases (Mother and Son) with Colorectal Polyposis

　家族性大腸ポリープ症（familial polyposis coli）は比較的稀な疾患であるが，大腸癌の発生頻度の高いことが知られており，全国調査（1961～72）の集計では，20歳以下で既に29％に達し，放置すれば全例が癌化すると推定されている¹⁾．一方，大

腸ポリープ症のほかに骨腫などの随伴病変を合併するGardner症候群は更に稀な疾患とされているが，最近では遺伝学的な研究も含め，家族性大腸ポリープ症との関連が注目されている．

　今回われわれは大腸ポリポーシスに下顎骨腫を随伴した症例と，その母で孤立性の大腸ポリープおよび頭部のsoft tumorを検出し得た症例を経験したので，これらの例に一部免疫学的検索も加え報告する．

　Two cases (mother and son) of suspected “Gardner's syndrome, occult form” are reported.

　Case 1 was a 15-year-old boy. He was admitted with a preliminary diagnosis of hypochromic anemia. Y-ray and endoscopic examination revealed numerous polyps in the large intestine. Two osteoma-like shadows were also found by orthopantomographical examination, but the presence of a soft tumor was not observed. Case 2 was a 40-year-old woman, the mother of case 1. No complaint was observed, but X-ray and endoscopic examinations revealed broadbased polyps in the sigmoid colon. She also had a epidermoid cyst on the left occipito-temporal side.

　Case 1 showed a slight increase of serum CEA levels and abnormal decrease of T lymphocytes; therefore, a certain immunodeficiency was suspected.

　Both cases were operated on six months of ter diagnosis and the histological feature of resected polyps in both cases showed a picture of adenocarcinoma.