胃癌を合併したボーエン病の４例

Abstract

Four cases of Bowen's disease associated with early gastric cancer were reported.Case 1. A 60-year old man visited our department in June, 1985, with a 17×19mm sized erythema on the penis. Bowen's disease was histologically diagnosed. Soft X-ray therapy cured the lesion. Examination of internal organs demonstrated lung cancer in February, 1986. A combination of chemotherapy and radiation exerted a complete remission. In December, 1987, X-ray examination of upper gastro-intestinal tract revealed multiple early gastric cancer (IIa+IIc, IIa, IIc, IIc). The patient underwent surgery.Case 2. A 79-year old man visited in September, 1987 with pigmented macules on the waist, abdomen and left axilla, sized 59×75mm, 20×18mm and 21×31mm respectively. Bowen's disease was histolocally diagnosed for the waist lesion and basal cell carcinoma were diagnosed for the others. Examination of internal organs revealed multiple early gastric cancer (I+IIa, IIc+IIa) in October, 1987. One month after the gastrectomy, the skin lesions were removed in December, 1987.Case 3. A 65-year old man visited in October, 1990 with a 10×15mm sized ulcer on the left index. The lesion was histologically diagnosed as Bowen's disease. The lesion was totally removed. Examination of internal organs showed an early gastric cancer (IIc) in January, 1991. So that gastrectomy was curried out.Case 4. A 73-year old man visited in January, 1991 with a 30×34mm sized pigmented macule on the left arm. The lesion was histologically diagnosed as Bowen's disease and totally removed. Examination of internal organs disclosed an early gastric cancer (IIa) in January, 1991. The patient refused our proposal of surgical operation.From January, 1985 to December, 1992, 43 patients with Bowen's disease visited our hospital. Sixteen patients of them were examined for the malignancy of internal organs. Eight patients (50%) of them were associated with malignant tumor, including 6 patients (37.5%) with internal malignancy. This study includes 3 patient who would have been killed by the tumor, if the internal examination were not suggested by their Bowen's disease. This result suggest the importance of internal examination in the patients with Bowen's disease.