[Gastric cancer arising from gastric polyps in gardner syndrome - a case report].
The patient was a 48-year-old woman who was diagnosed with early gastric cancer during a long-term follow-up period for Gardner syndrome. Subtotal colectomy for colon leiomyoma was performed when the patient was 22 years old. Partial resection of the ileum was performed for ileum leiomyoma at the age of 27. Total resection of the remaining colon with ileostomy was performed for a pelvic desmoid tumor at the age of 40. In addition, resection of a desmoid tumor of the abdominal wall was performed 8 times in the 25 years since the first operation. During the follow-up for gastric polyps associated with Gardner syndrome, gastric cancer was detected from biopsy specimens of a wide range of the fundus polyps. Endoscopic resection was considered not to be applicable because of the extensive nature of the lesion. Total gastrectomy was also considered not to be applicable because of concerns about short bowel syndrome due to intestinal reconstruction. Therefore, proximal gastrectomy with esophagogastric anastomosis was performed. The pathological diagnosis was 0-IIa, 70 × 44 mm, tub1, m, ly0, v0, n0, PM (-), DM (-), stageIA. The postoperative course was uneventful, and the patient was discharged on postoperative day (POD) 16. We speculate that long-term survival of patients with Gardner syndrome without severe short bowel syndrome might result in carcinogenesis of gastric polyps.
Dept. of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine.
Atsushi
A
Ikai
Hitoshi
H
Fujiwara
Atsushi
A
Shiozaki
Kazuma
K
Okamoto
Toshiyuki
T
Kosuga
Hirotaka
H
Konishi
Shuhei
S
Komatsu
Daisuke
D
Ichikawa
Ryo
R
Morimura
Yoshiaki
Y
Kuriu
Hisashi
H
Ikoma
Masayoshi
M
Nakanishi
Toshiya
T
Ochiai
Chouhei
C
Sakakura
Eigo
E
Otsuji
D018256:Adenomatous Polyps / Q000150:complications* / Q000601:surgery; D005260:Female; D005736:Gardner Syndrome / Q000150:complications* / Q000601:surgery; D005743:Gastrectomy; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000150:complications / Q000209:etiology / Q000473:pathology* / Q000601:surgery