A Case of Advanced Carcinoma Arising in Jejunum Polyps in Peutz-Jeghers Syndrome

Naoyuki Kobayashi, Masahiko Watanabe, Nobutaka Yasui, Masami Ishihara, Shin Narai, Hideki Tatematsu, Hidenori Tokuhara, Tatsuo Teramoto, Masaki Kitajima, Makio Mukai*

Department of Surgery and Pathology*, Keio University School of Medicine

We experienced a case of adenocarcinoma arising in jejunum polyps with lymph node metastasis in a patient with Peutz-Jeghers syndrome. A27-year-old man was admitted to our hospital with appetite loss and lower abdominal pain. He had a previous history of surgical resection of colon and jejunal polyps under the diagnosis of Peutz-Jehers syndrome at the ages of 3 and 14, and adhesiotomy for adhesional ileus at the age of 15. Small intestinal X-ray examination revealed a stenosis in the jejunum and polyps on the oral and anal side of that. An operation was performed. An irregular elevated lesion 5×6 cm in diameter was seen on the oral side of Treitz's ligament, and the small intestine was partially resected. Pathological findings showed the coexistence of well-differentiated adenocarcinoma confined to the subserosa and Peutz-Jeghers polyps. In this case paraintestinal lymph node metastasis was observed. He was discharged from the hospital without postoperative complications.

Key words
Peutz-Jeghers syndrome, adenocarcinoma in the intestinal polyps, lymph node metastasis of intestinal adenocarcinoma

Reprint requests
Naoyuki Kobayashi Department of Surgery, Keio University School of Medicine
35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582 JAPAN

Accepted
April 22, 1998

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