Chen Jing, Zhu Ming-Yuan, Huang Yan-Hua, Zhou Zhong-Cheng, Shen Yi-Yu, Zhou Quan, Fei Ming-Jian, Kong Fan-Chuang
Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China.
Department of Pathology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China.
World J Clin Cases. 2022 Sep 26;10(27):9790-9797. doi: 10.12998/wjcc.v10.i27.9790.
Synchronous primary cancers (SPCs) have become increasingly frequent over the past decade. However, the coexistence of duodenal papillary and gallbladder cancers is rare, and such cases have not been previously reported in the English literature. Here, we describe an SPC case with duodenal papilla and gallbladder cancers and its diagnosis and successful management.
A 68-year-old Chinese man was admitted to our hospital with the chief complaint of dyspepsia for the past month. Contrast-enhanced computed tomography of the abdomen performed at the local hospital revealed dilatation of the bile and pancreatic ducts and a space-occupying lesion in the duodenal papilla. Endoscopy revealed a tumor protruding from the duodenal papilla. Pathological findings for the biopsied tissue revealed tubular villous growth with moderate heterogeneous hyperplasia. Surgical treatment was selected. Macroscopic examination of this surgical specimen revealed a 2-cm papillary tumor and another tumor protruding by 0.5 cm in the gallbladder neck duct. Intraoperative rapid pathology identified adenocarcinoma in the gallbladder neck duct and tubular villous adenoma with high-grade intraepithelial neoplasia and local canceration in the duodenal papilla. After an uneventful postoperative recovery, the patient was discharged without complications.
It is essential for clinicians and pathologists to maintain a high degree of suspicion while evaluating such synchronous cancers.
在过去十年中,同步原发性癌症(SPCs)越来越常见。然而,十二指肠乳头癌和胆囊癌同时存在的情况很少见,英文文献中此前尚无此类病例的报道。在此,我们描述一例同时患有十二指肠乳头癌和胆囊癌的SPC病例及其诊断和成功治疗过程。
一名68岁的中国男性因过去一个月的消化不良主诉入住我院。当地医院进行的腹部增强计算机断层扫描显示胆管和胰管扩张以及十二指肠乳头处有占位性病变。内镜检查发现十二指肠乳头有肿瘤突出。活检组织的病理检查结果显示为管状绒毛状生长,伴有中度异质性增生。选择了手术治疗。对该手术标本的宏观检查发现一个2厘米的乳头状肿瘤以及另一个在胆囊颈部导管突出0.5厘米的肿瘤。术中快速病理检查确定胆囊颈部导管为腺癌,十二指肠乳头为管状绒毛状腺瘤伴高级别上皮内瘤变及局部癌变。术后恢复顺利,患者无并发症出院。
临床医生和病理学家在评估此类同步癌症时必须保持高度怀疑。