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KMID : 0870420070110030068
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2007 Volume.11 No. 3 p.68 ~ p.71
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A case of Combined Resection for Synchronous Primary Carcinoma of Gallbladder and Duodenum
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Hur Young-Hoe
Park Chang-Hwan
Lee Wan-Sik
Joo Young-Eun
Choi Sung-Kyu
Rew Jong-Sun
Kim Sei-Jong
Koh Yang-Seok
Jeong Soon-Ju
Kim Jung-Chul
Cho Chol-Kyoon
Kim Hyun-Jong
Sin Sang-Su
Jeong Yong-Yeon
Lee Jae-Hyuk
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Abstract
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Purpose: The incidence of multiple primary malignant tumor has ranged from 0.7% to 11% in the medical literature. Various organs in the digestive system are the sites of multiple primary cancer (MPC). MPC may be synchronous or metachronous depending on the interval between their diagnosis. To the best of our knowledge, there are only rare reports of resected cases of synchronous primary carcinomas that developed in the GB and duodenum.
Methods: We present here a patient who underwent an operation for synchronous primary carcinomas of the GB and duodenum. A 51-year-old female was admitted for postprandial abdominal discomfort. CT scan and MRI of the abdomen showed a 3 x 2 cm sized heterogenously enhancing mass in the GB and a 3.7 x 2.7 cm sized hetrogenously enhancing mass in the 2nd portion of the duodeum. The laboratory findings, including the tumor markers, were non-specific. An elective operation was done under the impression of combined GB cancer and cancer in the 2nd portion of the deuodenum. On the operative findings, there was a 3 x 2.5 cm sized mass in the GB and a 5 x 4 cm sized duodenal mass with near complete luminal obstruction 3 cm distal from the pyloric ring. Radical cholecystectomy with wedge resection of the liver bed and Whipple’s operation was performed.
Results: On microscopic examination, the GB mass was well differentiated adenocarcinoma and the duodenal mass was moderately differentiated adenocarcinoma, and one lymph node (a lymph node along the common hepatic artery) among the 18 dissected lymph nodes was invaded by tumor cells. The microscopic findings showed that the GB mass and duodenal mass were synchronous primary carcinomas. The patient recovered uneventfully and is alive and doing well without evidence of recurrence at 21-months of follow up evaluation.
Conclusions:We report here on a case of combined curative resection for synchronous primary carcinomas of the gallbladder and duodenum.
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KEYWORD
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Multiple primary cancer, Combined curative resection
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