An Operative Case of a Mucin Producing Pancreatic Tumor 9 years after the First Operation of Esophageal and Pulmonary Cancers

Takayuki Kaneko, Sigenori Sugihara, Hironori Kobayashi, Hiroaki Harada, Yosiaki Ikuta, Tetsuhiro Egami and Hiroaki Hongo^*

Department of Surgery, Shimonoseki Kousei Hospital

Department of Surgery, Yamaga Municipal Hospital^*

Recent advances of treatment for esophageal and lung cancer have contributed to the prolongation of survival for these cancer patients. Therefore, a second cancer after resection for these cancers has become troublesome. We experienced one case with cancers of the esophagus, pulmonary and pancreas. This case was a 71-year-old patient who underwent esophagectomy for esophageal cancer and right upper lobectomy for lung cancer, concurrently. Nine years after surgery, CT scan and magnetic resonance cholangio-pancreaticography showed a cystic lesion on the pancreatic head. This lesion was clinically diagnosed as a intraductal papillary adenocarcinoma of the pancreas. The major problem in surgery was preservation of feeding artery of the gastric roll used for reconstruction of esophago-gastrostomy after esophagectomy.
Pancreato-duodenectomy was successfully performed and its right gastroepiploic artery was preservated. In Japan, patient with second cancer following treatment of primary esophageal or pulmonary cancer have increased. Intensive observation for follow-up period may be necessary for early detection of second cancer and for improvement of the prognosis for such patients.

Key words
esophageal cancer, lung cancer, pancreatic cancer

Reprint requests
Takayuki Kaneko Department of Surgery, Shimonoseki Kousei Hospital3-3-8 Kamishinchi, Shimonoseki, 750-0061 JAPAN

Accepted
January 26, 2000

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