Abstract
Multiple cancer patients who achieve long-term survival are sometimes encountered. Multiple carcinogenesis may occur due to genetic or environmental characteristics. We report the case of a 74-year-old woman who was diagnosed with synchronous double carcinoma of the duodenal papilla and gall bladder without clinical symptoms, who underwent postoperative follow-up for familiar adenomatous polyposis coli with multiple colonic adenocarcinomas, ileal adenocarcinoma, left urinary tract neoplasm, and left upper lobe lung adenocarcinoma. Computed tomography also showed an intraductal papillary mucinous neoplasm of the pancreas and a lesion that was suspected to be uterine body carcinoma; however, they did not show any clear malignant behavior. No metastatic lesions of either of these biliary cancers were observed. Based on preoperative diagnostic imaging, subtotal stomach preserving pancreaticoduodenectomy with gall bladder bed liver resection with D2 lymphadenectomy was planned and R0 resection was achieved. The postoperative histological diagnosis showed early carcinoma of the duodenal papilla and gall bladder pyloric gland adenoma without node metastasis. The postoperative course was uneventful and the patient had a good prognosis without tumor recurrence or new malignant lesions for two years after the last operation, without adjuvant therapy. Six metachronous carcinomas of eight different organ neoplasms were diagnosed, which is rare. This represents the first reported case of ampullary carcinoma in a patient with sextuple cancer.
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Acknowledgements
The English in manuscript was edited by the expert editing company, Rise Japan #220854 on July 20, 2022. We thank Dr. Kazusada Shirao, who is a director of Japan Community Health care Organization (JCHO) Miyazaki Konan Hospital, for providing pathological records at the time of the first total proctocolectomy and resection of small intestine in this patient (in 1995 and 2014).
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Nanashima, A., Imamura, N., Nishida, T. et al. A rare case of long-term survival of a patient who underwent radical operations for sextuple malignancies. Clin J Gastroenterol 15, 1169–1172 (2022). https://doi.org/10.1007/s12328-022-01714-5
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DOI: https://doi.org/10.1007/s12328-022-01714-5