Two synchronous malignant tumors of the pancreas: a case report

W S L De Silva,D S Manawasinghe,S A P D Rajapakse,P S H Hettiarachchi,A A Pathirana,B K Dassanayake,I Prematilleke

doi:10.1186/s13256-017-1244-0

W S L De Silva, D S Manawasinghe + Show 5 more

Open Access

https://doi.org/10.1186/s13256-017-1244-0

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Abstract

BackgroundOnly a limited number of multiple synchronous primary malignancies of the pancreas have been reported in the medical literature. We report a case of two solid malignant tumors of the pancreas diagnosed preoperatively.Case presentationWe describe a 65-year-old Sri Lankan woman who presented with progressive obstructive jaundice. Initial contrast-enhanced computed tomography imaging detected a malignant tumor at the tail of her pancreas. A second tumor of the pancreatic head was detected with integrated imaging using multidetector computed tomography and multimodal magnetic resonance imaging. She underwent total pancreaticoduodenectomy and splenectomy. Gross examination of the specimen confirmed the presence of two separate tumors. Histology of the ampullary tumor showed pancreatic-type adenocarcinoma and the tumor in the tail of her pancreas showed a colloid-type adenocarcinoma. ConclusionThe possibility of multiple primary malignant solid tumors of different types with malignant potential has to be considered even without background pathology when managing multiple tumors in the pancreas.

Highlights

A limited number of multiple synchronous primary malignancies of the pancreas have been reported in the medical literature
De Silva et al Journal of Medical Case Reports (2017) 11:84 the distal common bile duct (CBD) stricture, a second computed tomography (CT) scan combined with multimodal magnetic resonance imaging (MRI) of her abdomen was performed
This combined CT/MRI of her abdomen detected a second tumor in her pancreas; it was a mass with ill-defined margins of 17×19 mm, which invaded adjacent pancreatic tissue just inferior to the distal end of her CBD

Summary

Conclusion

The possibility of multiple primary malignant solid tumors of different types with malignant potential has to be considered even without background pathology when managing multiple tumors in the pancreas.

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