Sclerodermoid Syndrome Associated with Internal Tumor. Presented by Dr. Morton Maxwell (by invitation), Carol Leland (by invitation), and Dr. Thomas H. Sternberg.
A 42-year-old single white male office worker has never been able to defecate without the use of enemas. He has had narcolepsy for 20 years. Two years ago he began having episodes of colicky abdominal pain with distention. One year ago a laparotomy was done; no abnormalities were found except a spastic segment of colon, which was resected. A solitary benign polyp was found in this segment. No other polyps were found with a subsequent sigmoidoscopy. During the past five months he has had swollen ankles. For three months he has had periodic edema and flushing of the face, abdomen, feet, and back.
Physical examination: B. P. 168/110. The skin of the face and neck presents evidence of atrophy, telangiectasia, and mottled pigmentation. There is a doughy