A Case of Gardner's Syndrome with Intra-abdominal Desmoid 7 Years after Total Colectomy

Manabu Futamura, Naoki Yokoo, Ryouji Okamoto, Takashi Shiriko, Hidekzau Yamamoto, Makoto Kume, Tetsuji Yoneyama, Shigeru Mori, Hisaya Azuma, Kei Yonezawa

Department of Surgery, Takayama Red Cross Hospital

We report a case of Gardner's syndrome with intra-abdominal desmoid 7 years after total colectomy. A 42-year-old male underwent a total colectomy because of Gardner's syndrome in 1986. An ascending colon cancer was found then, and a₁, n₁, P₀, H₀, M (-), stage III according to the General rules of colorectal cancer. He experienced a painless tumor in the left epigastral lesion since March 1992. Its size was enlarging during the last 9 months. Lip pigmentations; hyperplastic polyp in stomach and rectum; osteomas, impacted teeth, supernumerary tooth, cyst in the maxilla and the mandible were found as his physiological symptoms. Abdominal CT showed enhanced tumor. Angiography showed streteches and encasement of the jejunal arteries. In laparomomy, it was about 10 cm in size, and was thought to have originated from the mesenterium. But only biopsy was performed due to severe adhesion and fear of short bowel syndrome. Histological diagnosis was desmoid. He is now being treated with UFT and Tamoxifen.

Key words
Gardner's syndrome, intra-abdominal desmoid after total colectomy, lip pigmentation

Reprint requests
Manabu Futamura Department of Surgery, Takayama Red Cross Hospital
3-11 Tenma-cho, Takayama, 506 JAPAN

Accepted
November 1, 1993

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