Synchronous gallbladder and pancreatic cancer associated with pancreaticobiliary maljunction

doi:10.3748/wjg.v20.i39.14500

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Oct 21, 2014; 20(39): 14500-14504
Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14500

Synchronous gallbladder and pancreatic cancer associated with pancreaticobiliary maljunction

Narongsak Rungsakulkij, Paisarn Boonsakan

Narongsak Rungsakulkij, Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand

Paisarn Boonsakan, Department of Pathology, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand

Author contributions: Rungsakulkij N and Boonsakan P contributed equally to this manuscript.

Correspondence to: Narongsak Rungsakulkij, MD, Department of Surgery, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok 10400, Thailand. narongsak.run@mahidol.ac.th

Telephone: +66-2-2011315 Fax: +66-2-2011316

Received: November 12, 2013
Revised: June 25, 2014
Accepted: July 24, 2014
Published online: October 21, 2014
Processing time: 342 Days and 2.2 Hours

Abstract

We report the case of a 46-year-old woman who presented with chronic intermittent abdominal pain without jaundice; abdominal ultrasonography showed thickening of the gallbladder wall and dilatation of the bile duct. Endoscopic retrograde cholangiopancreaticography showed pancreatobiliary maljunction with proximal common bile duct dilatation. Pancreatobiliary maljunction was diagnosed. A computed tomography scan of the abdomen showed suspected gallbladder cancer and distal common bile duct obstruction. A pancreatic head mass was incidentally found intraoperative. Radical cholecystectomy with pancreatoduodenectomy was performed. The pathological report showed gallbladder cancer that was synchronous with pancreatic head cancer. In the pancreatobiliary maljunction with pancreatobiliary reflux condition, double primary cancer of the pancreatobiliary system should be awared.

Keywords: Pancreaticobiliary maljunction; Gallbladder cancer; Pancreatic cancer; Endoscopic retrograde cholangiopancreaticography

Core tip: We reported a case of 46-year-old women presented with chronic intermittent abdominal pain without jaundice. Endoscopic retrograde cholangiopancreaticography revealed pancreatobiliary maljunction. Radical cholecystectomy with pancreatoduodenectomy was performed. Pathological report showed gallbladder cancer synchronous with pancreatic head cancer. In the pancreatobiliary maljunction with pancreatobiliary reflux condition double primary cancer of pancreatobiliary system should be kept in mind.