A RESECTED CASE OF TRIPLE CANCER INVOLVING INTRADUCTAL PAPILLARY MUCINOUS ADENOCARCINOMA OF PANCREAS, BILE DUCT CANCER, AND GASTRIC CANCER IN AN AGED PERSON

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 65; no. 12; pp. 3344 - 3349
• Main Authors: NINOMIYA, Motoki, MIZUNO, Kenji, YOSHIYAMA, Tomoyuki, SHIOZAKI, Shigehiro, TAKAKURA, Norihisa, AOKI, Hideki
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2004
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.65.3344

An 87-year-old man who had been followed for intraductal papillary mucinous tumor (IPMT) of pancreas was admitted to the hospital because of development of jaundice. Upper gastrointestinal series revealed early gastric cancer at the pyloric antrum. We diagnosed the case as double cancer of intraductal papillary mucinous cancer (IPMC) of pancrease with invasion into the bile duct and duodenum and gastric cancer, and performed a pancreatoduodenectomy. On the resected material bile duct cancer in the upper bile duct was identified besides IPMC of pancreas and gastric cancer. Namely the patient had triple cancer. It is relatively common that IPMT occurs simultaneously with cancer of other organ, but triple cancer comprising IPMC of pancreas, bile duct cancer and gastric cancer is rare. The prognosis of such multiple cancers is often determined by cancers of other organs, so that a possible association with other organ malignancy must always be kept in mind in following patients with IPMT. Further this patient is the oldest of all patients undergone pancreatoduodenectomy as far as we could review. It suggests that even aged patients are able o have uneventful postoperative course, if appropriate preoperative assessment, postoperative management, and safe operation are made.