Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9790
Peer-review started: April 14, 2022
First decision: June 7, 2022
Revised: June 20, 2022
Accepted: August 16, 2022
Article in press: August 16, 2022
Published online: September 26, 2022
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.
Core Tip: Synchronous primary cancers (SPCs) of the duodenal papilla and gallbladder are rarely reported. Here, we report such a case. The lesion in the duodenal papilla was discovered by imaging examination of a 68-year-old man. Endoscopic biopsy was performed, and the pathological findings revealed moderate heterogeneous hyperplasia. The patient underwent pancreaticoduodenectomy, and intraoperative rapid histopathological examination surprisingly revealed adenocarcinoma in the papillary region and another adenocarcinoma in the gallbladder neck duct. SPC involving both the gallbladder and duodenal papilla is regarded as a rare occurrence. It is essential for the clinician and pathologist to maintain a high degree of suspicion while evaluating such lesions.