title: Cowden's disease diagnosed through mucocutaneous lesions and gastrointestinal polyposis with recurrent hematochezia, unrevealed by initial diagnosis.
abstract: A 51-year-old man was admitted to our hospital because of hematochezia and painful keratotic plaques involving both hands. He had gastrointestinal polyposis, and a history of liver hemangiomas and thyroid tumor. Numerous papules on the face and papillomatosis on the oral mucosa were present. A diagnosis was made as a typical case of Cowden's disease according to the criteria proposed by Salem and Steck (J Am Acad Dermatol 8: 686, 1983). The patient was not correctly diagnosed initially in spite of typical manifestations of Cowden's disease, mainly due to his concomitant manifestations which occurred chronologically.
authors.affiliation: Department of Internal Medicine, Tokyo Saiseikai Central Hospital.
authors.forename: M
authors.initials: M
authors.lastname: Kato
authors.forename: A
authors.initials: A
authors.lastname: Mizuki
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: T
authors.initials: T
authors.lastname: Kunihiro
authors.forename: H
authors.initials: H
authors.lastname: Nagata
authors.forename: N
authors.initials: N
authors.lastname: Tsukada
authors.forename: H
authors.initials: H
authors.lastname: Orikasa
authors.forename: S
authors.initials: S
authors.lastname: Morinaga
mesh_terms: D003951:Diagnostic Errors; D016099:Endoscopy, Gastrointestinal; D004935:Esophageal Diseases / Q000209:etiology / Q000473:pathology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006223:Hamartoma Syndrome, Multiple / Q000150:complications / Q000175:diagnosis*; D006391:Hemangioma / Q000209:etiology; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000209:etiology / Q000473:pathology; D012871:Skin Diseases / Q000209:etiology; D013964:Thyroid Neoplasms / Q000209:etiology