Korean J Hepatobiliary Pancreat Surg.  2007 Sep;11(3):68-71.

A case of Combined Resection for Synchronous Primary Carcinoma of Gallbladder and Duodenum

• Hur YH
• Jeong SJ
• Koh YS
• Kim JC
• Cho CK
• Kim HJ
• Joo YE
• Park CH
• Lee WS
• Choi SK
• Rew JS
• Kim SJ
• Shin SS
• Jeong YY
• Lee JH

Abstract

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.

Keyword

Multiple primary cancer; Combined curative resection

MeSH Terms

Abdomen
Adenocarcinoma
Cholecystectomy
Diagnosis
Digestive System
Duodenum*
Female
Follow-Up Studies
Gallbladder*
Humans
Incidence
Liver
Lymph Nodes
Magnetic Resonance Imaging
Middle Aged
Phenobarbital
Recurrence
Tomography, X-Ray Computed
Biomarkers, Tumor
Phenobarbital