A Case of Peutz-Jeghers Syndrome with Focal Cancer in polyps of the Small Intestine and Colon

Takayoshi Fujimoto, Motohisa Takami, Yukiyasu Okumura, Toshiaki Takada, Masayuki Kitada, Yasuo Tsukahara, Takashi Shibata, Masahiro Murotani, Keisuke Iihara, Taro Watanabe, Yasunori Watanabe, Satoru Ohshima, Masahiru Kimura

Department of Surgery, Toyonaka Municipal Hospital

A 27-year-old woman was admitted to our hospital with anal bleeding and abdominal pain. Cutaneous pigmentation was found her lips and the fingers of both hands. The patient's daughter, aged, 2, also had pigmentation on her lips. Small intestinal X-ray examination revealed various sized polyps in the jejunum and ileum. Barium enema demonstrated many small polyps in the left side of the colon, and one large one each in the distal descending colon and sigmoid colon. Gastroduodenoscopy showed numerous minute polyps in the stomach and several various sized polyps in the duodenum. Left hemicolectomy and partial resction were performed, and polyps of the duodenum and jejunum were removed by enterotomy. Fifteen polyps in the small intestine and 15 in the large intestine were removed. All polyps were histologically hamartoma. One each of the polyps of the jujunum and the sigmoid colon included focal cancer and adenoma along with hamartoma. This finding implies a malignant change of Peutz-Jeghers' polyps.

Key words
Peutz-Jeghers syndrome, carcinoma, adenoma

Reprint requests
Takayoshi Fujimoto Department of Surgery, Toyonaka Municipal Hospital
2-1-1 Okauenomachi, Toyonaka, 560 JAPAN

Accepted
July 8, 1994

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