Simultaneous Gallbladder Carcinoma and Gist of the Stomach, a Rare Case of Multiple Primary Malignant Tumors: A Case Report

Abstract

Background: Multiple primary malignant tumors are defined as two concurrent cancers from differing histologic origins. The presence of two concomitant malignancies raises challenges regarding treatment approach and coordination of neoadjuvant, surgical, and adjuvant therapies. The existing data and treatment approaches to multiple primary malignant tumors are limited. Methods: Review of an interesting case presentation. Results: In this case report, we present the case of a 76-year-old female who presented with a synchronous gastrointestinal stromal tumor of the stomach and gallbladder adenocarcinoma. She underwent diagnostic laparoscopy, Intra-op Ultrasound, laparoscopic gastric wedge resection of the lesser curvature GIST, and cholecystectomy with limited portal lymphadenectomy. The pathology report demonstrated a pT1bN0M0 well-differentiated papillary adenocarcinoma of the gallbladder, and a pT2pN0M0 low-grade gastrointestinal stromal tumor. Her case was presented at a multidisciplinary tumor board which ultimately recommended six months of adjuvant capecitabine. Her five-month follow up PET scan was negative for local recurrence or metastatic disease. Conclusion: There is currently limited literature regarding treatment approaches to multiple primary malignant tumors. As such, each case must be thoroughly discussed and reviewed. In this case report, the tumors were able to be resected within a single anesthesia event and single surgical field. Additionally, only one of the tumors merited adjuvant chemotherapy. Further investigation into multiple primary malignant tumors with conflicting treatment approaches will provide further insight into these rare and challenging cases. KeywordsGallbladder Carcinoma, Multiple Primary Malignant tumors, Gastrointestinal Stromal Tumor, GIST