Case 1 is an 84-year-old Japanese man with previous medical history of hypertension, chronic hepatitis C infection, idiopathic thrombocytopenic purpura and colon polyps (tubular adenoma and tubulovillous adenoma). He had no mucocutaneous pigmentation or family history of PJS. An upper gastrointestinal endoscopy revealed a lobular polyp measuring 14 mm in diameter, in the superior duodenal angle (Figure ). Endoscopic mucosal resection was performed without complication and histological examination showed findings suggestive of a hamartomatous polyp--branching bundles of smooth muscle fibers covered by hyperplastic duodenal mucosa--with a focus of well-differentiated adenocarcinoma (Figure ). A colonoscopy and small-intestinal follow-through showed no other polyps.
We report a case of a 37 year old man who admitted to our hospital with complaint of occasionally painless rectal bleeding since 8 years ago which had exacerbated with no history of weight loss, abdominal pain, loss of appetite or anal pain. He had no significant past medical history or significant family history of GI malignancy. In physical examination he did not had any pigmentation in mucocutaneous and any abnormal finding in abdomen and rectal examination.\nGastrointestinal endoscopy revealed multiple polyps located in the deuodenum and less than 100 polyps in colon with aggregation in left colon and sigmoid with pathology of juvenile polyposis.\nA barium enema he had mucosal lesions in keeping with polyps in sigmoid (). A laparotomy was performed and multiple giant polyps entire colon was found. Total abdominal proctocolectomy and J pouch ileoanal anastomosis and omentectomy was performed and a diverting ileostomy was inserted. Histopathological evaluations of the polyps revealed hamartomatous polyps in keeping with a diagnosis of Peutz Jeghers syndrome ().