A CASE OF SYNCHRONOUS DOUBLE CANCER OF THE ESOPHAGUS AND GALLBLADDER SUCCESSFULLY DIAGNOSED PREOPERATIVELY

Abstract

A 77-year-old man, who had been treated for pulmonary tuberculosis and bronchial asthma at a nearby hospital, noticed right hypochondralgia in May 1992. Ultrasonography indicated gallstone and a gallbladder tumor and he was referred to the hospital. With examinations a diagnosis of synchronous double cancer of the esophagus and gallbladder was made. Because of his advanced age and pulmonary complications, closed heart evultion of the esophagus with cervical esophagus-gastric tube anastomosis and extended cholecystectomy with lymph node dissection (R2) were performed. The esophageal tumor was well differentiated squamous cell carcinoma with wall invasion of sm; while the cystic tumor was adenosquamous cell carcinoma with wall invasion of ss and n2(+) in stage III. Postoperatively suture failure and respiratory failure developed, but which were successfully managed and the patient was discharged from the hospital on 170th hospital day. Synchronous double cancer of the esophagus and gallbladder is rare, and only 6 cases including this case have been seen in the Japanese literature, which included 2 cases of synchronous triple cancer. Among them preoperative diagnosis could be achieved only in this case. It is said that double cancer of the esophagus and other organ has a poor prognosis because of the difficulty in treating esophageal cancer and coexistence of other organ cancer. For this reason the therapeutic guideline should be decided carefully.