慢性関節リウマチに胆道系悪性腫瘍を合併した3例

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The relationships between rheumatoid arthritis and malignant disease have been a focus of controversy for many years. Many studies of patients with rheumatoid arthritis have found no increases in overall cancer rates. Although significant elevations in rates of lymphoma, myeloma and malignant disease in patients treated with immunosuppressive drugs have been reported, it has beenconsidered that gastrointestinal and biliary tract cancer in patients with rheumatoid arthritis is rare. We recently experienced three cases of rheumatoid arthritis with biliary tract cancer. They were gall bladder, cancer, bile duct cancer and cancer of papilla of Vater. Patients with rheumatoid arthritis should be carefully monitored for malignant disease.一般的に,慢性関節リウマチには悪性腫瘍の合併は少ないと言われている｡特に,消化器系あるいは胆道系悪性腫瘍を合併したという報告は極めて少ない｡我々は慢性関節リウマチの経過中,胆道系悪性腫瘍を合併した3例を経験した｡3症例はそれぞれ胆嚢癌,肝内胆管癌,乳頭部癌を合併していた｡非常に稀な症例であり,文献的考案を含め報告する｡