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Published in: Journal of Medical Case Reports 1/2017

Open Access 01-12-2017 | Case report

Two synchronous malignant tumors of the pancreas: a case report

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

Published in: Journal of Medical Case Reports | Issue 1/2017

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Abstract

Background

Only 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 presentation

We 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.

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.
Literature
1.
go back to reference Sastry A, Wayne M, Steele J, et al. Three synchronous, sporadic and separate periampullary and pancreatic tumors: more than a coincidence? World J Surg Oncol. 2014;12:382.CrossRefPubMedPubMedCentral Sastry A, Wayne M, Steele J, et al. Three synchronous, sporadic and separate periampullary and pancreatic tumors: more than a coincidence? World J Surg Oncol. 2014;12:382.CrossRefPubMedPubMedCentral
2.
go back to reference Goong HJ, Moon JH, Hyun Choi HJ, et al. Synchronous Pancreatic Ductal Adenocarcinomas Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Biopsy. Gut Liver. 2015;9(5):685–8.CrossRefPubMedPubMedCentral Goong HJ, Moon JH, Hyun Choi HJ, et al. Synchronous Pancreatic Ductal Adenocarcinomas Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Biopsy. Gut Liver. 2015;9(5):685–8.CrossRefPubMedPubMedCentral
3.
go back to reference Koji Y, u S, Hatori T, et al. Pancreatic Ductal Adenocarcinoma Derived From IPMN and Pancreatic Ductal Adenocarcinoma Concomitant with IPMN. Pancreas. 2011;40(4):571–80.CrossRef Koji Y, u S, Hatori T, et al. Pancreatic Ductal Adenocarcinoma Derived From IPMN and Pancreatic Ductal Adenocarcinoma Concomitant with IPMN. Pancreas. 2011;40(4):571–80.CrossRef
4.
go back to reference Imamura N, Chijiiwa K, Ohuchida J, et al. Synchronous solid pseudopapillary neoplasm and intraductal papillary mucinous neoplasm of the pancreas: report of a case. Surg Today. 2011;41(6):865–71.CrossRefPubMed Imamura N, Chijiiwa K, Ohuchida J, et al. Synchronous solid pseudopapillary neoplasm and intraductal papillary mucinous neoplasm of the pancreas: report of a case. Surg Today. 2011;41(6):865–71.CrossRefPubMed
5.
go back to reference Zhou H, Schaefer N, Wolff M, Fischer H-P. Carcinoma of the Ampulla of Vater Comparative Histologic/Immunohistochemical Classification and Follow-up. Am J Surg Pathol. 2004;28(7):875–82.CrossRefPubMed Zhou H, Schaefer N, Wolff M, Fischer H-P. Carcinoma of the Ampulla of Vater Comparative Histologic/Immunohistochemical Classification and Follow-up. Am J Surg Pathol. 2004;28(7):875–82.CrossRefPubMed
6.
go back to reference Lin F, Wang HL. Chapter 25: Pancreas and ampulla. Tables 25.1 and 25.6. In: Lin F, Prichard J, editors. Handbook of Practical Immunohistochemistry, vol. 2. New York: Springer-Verlag; 2015. p. 482–8. ISBN 978-1-4939-1577-4. Lin F, Wang HL. Chapter 25: Pancreas and ampulla. Tables 25.1 and 25.6. In: Lin F, Prichard J, editors. Handbook of Practical Immunohistochemistry, vol. 2. New York: Springer-Verlag; 2015. p. 482–8. ISBN 978-1-4939-1577-4.
7.
go back to reference Zhu L, Kim K, Domenico DR, et al. Adenocarcinoma of duodenum and ampulla of Vater: clinicopathology study and expression of p53, c-neu, TGF-alpha, CEA, and EMA. J Surg Oncol. 1996;61(2):100–5.CrossRefPubMed Zhu L, Kim K, Domenico DR, et al. Adenocarcinoma of duodenum and ampulla of Vater: clinicopathology study and expression of p53, c-neu, TGF-alpha, CEA, and EMA. J Surg Oncol. 1996;61(2):100–5.CrossRefPubMed
8.
go back to reference Scialpi M, Reginelli A, Gravante S, Falcone G, Baccari P, Manganaro L, Palumbo B, Cappabianca S. Pancreatic tumors imaging: An update. Int J Surg. 2016;28 Suppl 1:S142–55.CrossRefPubMed Scialpi M, Reginelli A, Gravante S, Falcone G, Baccari P, Manganaro L, Palumbo B, Cappabianca S. Pancreatic tumors imaging: An update. Int J Surg. 2016;28 Suppl 1:S142–55.CrossRefPubMed
Metadata
Title
Two synchronous malignant tumors of the pancreas: a case report
Authors
W. S. L. De Silva
A. A. Pathirana
I. Prematilleke
S. A. P. D. Rajapakse
P. S. H. Hettiarachchi
D. S. Manawasinghe
B. K. Dassanayake
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2017
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-017-1244-0

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