A CASE OF BULLOUS PEMPHIGOID COMPLICATED BY CANCER OF THE DESCENDING COLON

Abstract

This paper describes a case of bullous pemphigoid complicated by cancer of the descending colon, with a review of the Japanese literature. A 76-year-old man was admitted to the hospital because of left flank pain and skin vesicles. Physical examination showed tenderness and a palpable mass in the left flank, and there were tense pruritic bullae over the abdomen and thighs. Blood examination showed a CEA value of 5.6ng/dl, and the proportion of eosinophils was 9.5%. These figures were slightly above normal. X-ray examination and endoscopy of the large intestine showed a type 2' tumor of the descending colon. Biopsy showed evidence of malignancy. A histopathological diagnosis of bullous pemphigoid was made by direct and indirect fluorescent antibody techniques. An operation for cancer of the descending colon was performed. After the operation, the bullae disappeared and no signs of recurrence of bullous pemphigoid have been apparent for 4 months. Up to now there have been 56 cases (58 lesions) of bullous pemphigoid complicated by malignant tumor, including this case, and cancers of the digestive tract accounts for 69.0% of these tumors. Many people think that these complications purely coincidentally occur in the elderly. However, cases in which bullae disappear rapidly after resection of the tumor, such as this case, occur every now and then, and it is considered that there could be a causal relationship between bullous pemphigoid and malignant tumor.