A Resected Case of Simultaneous Cholangiocarcinoma and Advanced Gastric Cancer

Hideo Kato, Takeaki Shimizu*, Osamu Sato*, Katsujuki Uchida, Kazuhiro Tsukada, Terukazu Muto

First Department of Surgery, Niigata University School of Medicine
*Department of Surgery, Shinrakuen Hospital

We frequently experience double cancers in the stomach and an other organ. However, gastric cancer is rarely combined with cholangiocarcinoma. We report a case of advanced gastric cancer found simultaneously with cholangiocarcinoma. The patient was a 73-year-old man admitted to our hospital because of palpitation and shortness of breath. Laboratory tests revealed elevation of serum CEA and CA19-9 levels. Endoscopic study of the upper gastrointestinal tract showed a Borrmann 2 type tumor at the upper body of the stomach. A plain CT scan showed an irregular low density area which was enhanced by contrast medium, in the lateral segment of the liver. These lesions were successfully resected in one stage operation by total gastrectomy with splenectomy and distal pancreatectomy and left hepatic lobectomy. The resected specimens showed a 4.0×2.7 cm Borrmann 2 type lesion in the upper body of the stomach and a 6.5×3.5×8.0-cm nodular infiltrating tumor in the lateral segment of the liver. Microscopic examination revealed moderately differentiated adenocarcinoma in the stomach and welldifferentiated tubular adenocarcinoma in the liver. The postoperative course went well, and the patient is still alive more than 1.5 years after the operation. We concluded that positive surgical treatment which may give a good prognosis should be considered, if it is possible to perform a radical operation for the double cancer.

Key words
double cancer, gastric cancer, cholangiocarcinoma

Reprint requests
Hideo Kato First Department of Surgery, Niigata University School of Medicine
1-757 Asahimachidouri, Niigata, 951 JAPAN

Accepted
March 3, 1993

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