A CASE OF PERIANAL BOWEN'S DISEASE ASSOCIATED WITH AN EARLY GASTRIC CANCER

Abstract

A 72 years old man was seen at the hospital because of perianal itching lasting for 15 years. Irregular and brownish plaques appeared perianal skin. With preoperative incisional biopsies, the diagnosis of perianal Bowen's disease was made. He was admitted to the hospital for surgical operation. Wide local excision of perianal skin and epithelia of the anal canal were performed at the first operation. The resected margins of epithelia were proved displasia that was confirmed by postoperative histopathological findings. Upper gastrointestinal endoscopy revealed early gastric cancer. Re-operation (local excision of the anal canal) and distal gastrectomy were performed. The resected margins of epithelia at the second operation were also proved displasia. But no operation was added for conservation of the anal function. The patient is strictly followed up on an ambulant basis. There has been no displasia in the anal area nor distant metastasis. Dermatology textbooks state that persons with Bowen's disease have an increased risk to develop internal malignancy and the disease is relatively common in the aged. We consider that the patient with Bowen's disease should be explored for probable malignancy of other organs.