A Surgical Case of Synchronous Double Primary Cancers of the Bile Duct and Pancreas

Abstract

A 54-year-old woman was seen at another hospital because of jaundice. Computed tomography showed an unclear boundary and a poorly enhanced mass lesion in the pancreatic body, measuring 28 mm in diameter. Magnetic resonance cholangiopancreatography showed stenosis of the lower bile duct and the main pancreatic duct in the pancreatic body, and slight dilatation of the main pancreatic duct in the pancreatic tail. According to these findings, the preoperative diagnosis was synchronous double cancers of primary lower bile duct cancer and pancreatic body cancer. We performed pylorus-preserving pancreaticoduodenectomy with splenic artery and vein resection. A histopathologic examination revealed that the lower bile duct tumor was moderately differentiated tubular adenocarcinoma, and the pancreatic body tumor was moderately differentiated tubular adenocarcinoma. These 2 tumors showed no histopathologic continuity. According to these pathologic findings, we gave the patient a diagnosis of synchronous double cancers of primary lower bile duct cancer and pancreatic body cancer. The patient was discharged from the hospital on the 48th day after surgery. However, she died of multiple organ failure due to cancer recurrence 22 months after surgery.