title: Resection of triple synchronous cancers: a case report.
abstract: We herein present a case of synchronous triple cancer, which was successfully resected in a curative manner. These cancers consisted of primary duodenal, pancreatic and lung cancers, which were diagnosed in an asymptomatic 74 year-old male, who was referred to our department on December 14, 1996. On admission, his laboratory data showed no abnormality, including tumor markers (CEA 1.0, CA 19-9 1.0, AFP 8.1 U/ml), but he did show an impaired pulmonary function (FEV1.0: 57%). Upper gastrointestinal endoscopy showed a smooth surfaced duodenal tumor measuring 4 cm in size. The second tumor was found at the head of the pancreas by computed tomography (CT), showing a hypervascular mass measuring 3.0 cm, along with neighboring multiple cysts. In endoscopic retrograde cholangiopancreatography (ERCP), marked mucous secretion was observed through the papilla, while a filling defect was found in the dilated pancreatic duct. In a routine chest X-ray, a third tumor, which measured 1.5 cm in diameter, was recognized in the right upper lobe of the lung, and a moderately differentiated squamous cell carcinoma was also detected by a percutaneous CT guided biopsy. The pancreatic and duodenal tumors were surgically resected by a pancreatoduodenectomy (Stage I) in January 1997 and, 5 months later, a lung tumor underwent partial resection (Stage I). This patient tolerated these surgical procedures well and presently leads a normal, healthy life after discharge. In summary, a successful resection of synchronous triple cancers, which has never been previously reported in this specific combination, is described.
authors.affiliation: First Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Taira
authors.forename: M
authors.initials: M
authors.lastname: Shiraishi
authors.forename: H
authors.initials: H
authors.lastname: Sunagawa
authors.forename: Y
authors.initials: Y
authors.lastname: Takushi
authors.forename: H
authors.initials: H
authors.lastname: Shimoji
authors.forename: S
authors.initials: S
authors.lastname: Tomita
authors.forename: K
authors.initials: K
authors.lastname: Honma
authors.forename: Y
authors.initials: Y
authors.lastname: Muto
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000601:surgery*; D000232:Adenofibroma / Q000235:genetics / Q000601:surgery*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004273:DNA, Neoplasm / Q000032:analysis; D004379:Duodenal Neoplasms / Q000235:genetics / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics / Q000601:surgery*; D008297:Male; D018895:Microsatellite Repeats; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011013:Pneumonectomy
chemical_list: D004273:DNA, Neoplasm