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Journal of Gastroenterology

, Volume 38, Issue 1, pp 97–100 | Cite as

A case of triple synchronous cancers occurring in the gallbladder, common bile duct, and pancreas

  • Koichi Sato
  • Takeo Maekawa
  • Kiyotaka Yabuki
  • Yoshihisa Tamasaki
  • Hiroshi Maekawa
  • Keizo Kudo
  • Hironobu Sengoku
  • Ikukyo Kawa
  • Ryo Wada
  • Michio Matsumoto
Case report

We report a 74-year-old man with triple synchronous cancers occurring in the gallbladder, common bile duct, and pancreas. The patient had consulted a nearby physician because of epigastralgia and icterus. On September 30, 1997, the patient was admitted to our department for further evaluation and treatment. Abdominal computed tomography (CT) showed dilatation of the common bile duct, cystic duct, and intrahepatic bile duct, and swelling of the gallbladder. On CT, the wall of the distal common bile duct was thick and a low-density mass was detected on the left side. Cholangiography, performed via percutaneous transhepatic cholangiodrainage (PTCD), revealed stenosis of the distal common bile duct. Endoscopic retrograde pancreatography (ERP) showed marked dilatation of the main pancreatic duct. On October 17, 1997, pancreatoduodenectomy was performed under the diagnosis of carcinoma of common bile duct and pancreas. Histopathological examination revealed poorly differentiated tubular adenocarcinoma of the common bile duct, well-differentiated tubular adenocarcinoma of the gallbladder, and mucinous cystadenocarcinoma of the pancreas. These three tumors were histopathologically different. Moreover, p53-positive nuclei were recognized only in the pancreas tumor. These findings suggested that the oncogenic mechanisms of multiple synchronous cancers were not the result of only abnormal DNA reparative mechanisms.

Key words: triple synchronous cancers gallbladder common bile duct pancreas 

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Copyright information

© Springer-Verlag Tokyo 2003

Authors and Affiliations

  • Koichi Sato
    • 1
  • Takeo Maekawa
    • 1
  • Kiyotaka Yabuki
    • 1
  • Yoshihisa Tamasaki
    • 1
  • Hiroshi Maekawa
    • 1
  • Keizo Kudo
    • 1
  • Hironobu Sengoku
    • 1
  • Ikukyo Kawa
    • 1
  • Ryo Wada
    • 2
  • Michio Matsumoto
    • 2
  1. 1. Department of Surgery, Juntendo Izunagaoka Hospital, Juntendo University School of Medicine, 1129 Nagaoka, Izu-nagaoka-cho, Tagata-gun, Shizuoka 410-2295, JapanJP
  2. 2. Department of Pathology, Juntendo Izunagaoka Hospital, Juntendo University School of Medicine, Shizuoka, JapanJP

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