Khalifa Ali, Broder Arkady
Internal Medicine, Saint Peter's University Hospital/Rutgers Robert Wood Johnson School of Medicine, New Brunswick, USA.
Gastroenterology and Hepatology, Saint Peter's University Hospital/Rutgers Robert Wood Johnson School of Medicine, New Brunswick, USA.
Cureus. 2021 Aug 15;13(8):e17195. doi: 10.7759/cureus.17195. eCollection 2021 Aug.
The incidence of double primary tumors has been rising over the past few decades. Synchronous pancreatic and esophageal carcinomas are rarely reported in the literature. In this case report, we present an 86-year-old man who developed synchronous double cancers of the pancreas and esophagus. He has a past medical history of hypertension and prior nicotine dependence and was admitted for abdominal pain and weight loss. Laboratory data on admission were normal except for the serum carbonic anhydrase 19-9 (54 U/mL, reference range: 0-34 U/mL) and carcinoembryonic antigen (712.4 ng/mL, reference range: less than <5.0 ng/mL). Abdominal ultrasonography revealed a 2.3 cm lesion at the head of the pancreas. A CT scan with contrast was highly suspicious for pancreatic head malignancy. The patient underwent endoscopical ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) that showed a large non-obstructing ulcerating mass at the gastroesophageal junction (GEJ) as well as a pancreatic head mass. Histological findings from the obtained tissue demonstrated pancreatic adenocarcinoma and intestinal-type adenocarcinoma of the esophagus with an invasion of lamina propria, and diagnosis of double cancers of the pancreas and esophagus was made. In conclusion, our case report represents the fifth documented case of dual primary malignancy of the esophagus and pancreas. This highlights that, despite their rarity, primary distant malignancies in patients with pancreatic cancer is an entity that clinicians should be more cognizant about especially among the male smoker/ex-smoker patient population, specifically given that the current data demonstrate that the prognosis of double cancers primarily depends on the prognosis of the pancreatic carcinoma.
在过去几十年中，双原发性肿瘤的发病率一直在上升。同步性胰腺癌和食管癌在文献中鲜有报道。在本病例报告中，我们介绍了一名86岁的男性，他患有同步性胰腺癌和食管癌。他有高血压病史和既往尼古丁依赖史，因腹痛和体重减轻入院。入院时实验室检查数据除血清碳酸酐酶19-9（54 U/mL，参考范围：0-34 U/mL）和癌胚抗原（712.4 ng/mL，参考范围：小于<5.0 ng/mL）外均正常。腹部超声检查显示胰腺头部有一个2.3 cm的病变。增强CT扫描高度怀疑胰腺头部恶性肿瘤。患者接受了内镜超声检查（EUS）和内镜逆行胰胆管造影（ERCP），结果显示在胃食管交界处（GEJ）有一个大的非阻塞性溃疡性肿块以及胰腺头部肿块。所取组织的组织学检查结果显示为胰腺腺癌和食管肠型腺癌，侵犯固有层，诊断为胰腺癌和食管癌双癌。总之，我们的病例报告是食管和胰腺双原发性恶性肿瘤的第五例文献记载病例。这突出表明，尽管罕见，但胰腺癌患者中的原发性远处恶性肿瘤是临床医生应更加认识到的一种情况，特别是在男性吸烟者/戒烟者患者群体中，特别是考虑到目前的数据表明双癌的预后主要取决于胰腺癌的预后。
