Eiji Taruya

Nonfunctioning islet cell carcinoma presenting bleeding gastric varices and splenomegaly

This is a report of a 63-year-old Japanese woman with a nonfunctioning islet cell carcinoma of the pancreas presenting bleeding gastric varices and splenomegaly. These manifestations are extremely rare in patients with nonfunctioning islet cell tumor. The tumor originated in the tail of the pancreas and grew mainly within the spleen. The gastric varices due to increased blood flow to the tumor and arteriovenous fistuals within the tumor were confirmed by angiography and operation. The tumor was resected and she is in a good health for 14-months after the operation.

A CASE REPORT OF JUVENILE MULTIPLE COLO-RECTAL POLYPS WITH PROTEIN LOSING GASTROENTEROPATHY

A 14-year-old girl was admitted to the hospital because of watery diarrhea and edema of the lower extremities. Barium enema and endoscopy of the large intestine revealed multiple colorectal polyps with a circumferential IIa. group-like elevated lesion at the rectum. Leakage of isotopes from the rectum to the sigmoid colon was proved on 99mTc-HSA scintigram, and marked hypoproteinemia (TP 3.7g/dl), low level of IgG and increase in α1-antitrypsin clearance were recognized. From the above findings a diagnosis of multiple cold-rectal polyps with protein losing gastroenteropathy was made. Although the intestinal lesion in this patient was a tubular adenoma with slight atypia, it was a so-called IIagroup-like lesion macroscopically, assuming a form whose canceration rate is called high, and was complicated with protein losing gastroenteropathy. And hence proctosigmoidectomy was performed though the patient was young. This paper describes this case together with some literature discussion.