Abstract
Most patients with familial adenomatous polyposis (FAP) undergo prophylactic colectomy. As a result, extracolonic manifestations including benign and malignant tumors are more common in patients with FAP, and duodenal cancer is now the main cause of death. However, duodenal adenomas and carcinomas are detected less frequently in Korea and Japan than in Western countries, and gastric cancer is more prevalent than in Western countries. In the present case, a 63-year-old man, who had undergone a total colectomy and an ileostomy 14 years previously, presented at our outpatient clinic complaining of discomfort at the ileostomy site. The patient had adenomas in the gallbladder and ileum, and adenocarcinomas in the duodenum and stomach. The interval between development of duodenal cancer and stomach cancer was only 4 months. Therefore, we suggest that more frequent endoscopic surveillance may be needed for these cases.
저자들은 가족성샘종폴립증 환자가 대장 외 증상으로 회장과 담낭에 용종이 있었고, 짧은 간격의 추적 상부위장관내시경 검사를 시행했음에도 불구하고 십이지장 유두부 선암종과 위의 바닥샘종과 연관된 위 선암종이 발생한 증례를 경험하였다. 과거와 비교하여 가족성샘종폴립증 환자들이 선암종이 발생하기 전에 예방적으로 대장 절제술을 받는 경우가 증가하면서 대장 외 증상으로 인한 사망률이 점차 증가하고 있다. 내시경과 초음파를 이용한 주기적인 추적검사가 필요할 것으로 생각한다.
