Cowden syndrome in a male patient with metachronous triple cancers and various clinical features:a case report

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  • SAIKI Takuto
    Division of Gastroenterology, Yamaguchi Red Cross Hospital Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • HARADA Akira
    Division of Gastroenterology, Yamaguchi Red Cross Hospital Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • UMENO Junji
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • IWATAKE Shiro
    Division of Gastroenterology, Yamaguchi Red Cross Hospital Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • KAJIYA Yu
    Division of Gastroenterology, Yamaguchi Red Cross Hospital Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • TANIGUCHI Yoshiaki
    Division of Gastroenterology, Yamaguchi Red Cross Hospital Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • MORISAKI Shinji
    Division of Gastroenterology, Yamaguchi Red Cross Hospital Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • NAGASUE Tomohiro
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University
  • SUEKANE Hiroshi
    Division of Gastroenterology, Yamaguchi Red Cross Hospital
  • TORISU Takehiro
    Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University

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Other Title
  • 3重複癌を異時性に発症し，多彩な臨床徴候を呈した，Cowden症候群の男性の1例

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<p>A 66-year-old male patient with a thyroid and nasopharyngeal cancer history visited our hospital because of a positive fecal occult blood test. Total colonoscopy detected sessile or subpedunculated polyps in the ascending colon, sigmoid colon, and rectum. These polyps were endoscopically resected, and the rectal polyp was pathologically diagnosed as adenocarcinoma in adenoma and the others as adenomas. Additionally, multiple sessile lesions were revealed in the sigmoid colon and rectum. A complete gastrointestinal tract examination revealed multiple foci of glycogenic acanthosis in the esophagus, multiple sessile lesions in the stomach, multiple sessile lesions, clubbings (rod-shaped lesions), and venous malformations in the small bowel. Mucocutaneous examination indicated hemangiomas on the body trunk, patchy pigmentation on the glans penis, and keratotic papules in the inguinal region. The National Comprehensive Cancer Network diagnostic criteria for Cowden syndrome were used in this case. The patient met four major and two minor criteria;thus, Cowden syndrome was diagnosed. Moreover, the patient was had phosphatase and tensin homolog deleted on chromosome 10 gene mutation. This is the first reported case of metachronal triple cancers in a male patient with Cowden syndrome, and our results indicate the importance of cancer surveillance.</p>

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