Abstract
Background:Giant hamartomatous polyps in Peutz-Jegher's syndrome are very rare, and preoperative diagnosis is difficult, especially when they originate in the small intestine. A cytological description of hamartomatous polyps in Peutz -Jegher's syndrome has not been reported until now.
Case:A 38-year-old man was admitted with the complaint of abdominal pain. His family history was negative for familial polyposis. Multiple large masses were found in the small intestine by ultrasonography, CT, and barium-X ray of the small intestine. Partial ileal resection and colonic polypectomy were emergently performed for ileus and intussusception. The largest solid tumor was about 8.7×7.1×4.8 cm in size. Carcinomatous transformation was suspected because of the mucinous appearance of the cut surface of the intramural lesion, but intraoperative cytological examination of many areas of the lesion excluded carcinomatous transformation.
Conclusion: We diagnosed a hamartomatous polyp in Peutz-Jegher's syndrome by intraoperative cytology and based on pigmentation of the oral cavity, lips, fingers and sole. Intraoperative cytological examination was useful as it allowed us to examine a wide area of the very large tumor in the present case.
