Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2022; 10(27): 9790-9797
Published online Sep 26, 2022. doi: 10.12998/wjcc.v10.i27.9790
Synchronous primary duodenal papillary adenocarcinoma and gallbladder carcinoma: A case report and review of literature
Jing Chen, Ming-Yuan Zhu, Yan-Hua Huang, Zhong-Cheng Zhou, Yi-Yu Shen, Quan Zhou, Ming-Jian Fei, Fan-Chuang Kong
Jing Chen, Ming-Yuan Zhu, Yan-Hua Huang, Zhong-Cheng Zhou, Yi-Yu Shen, Fan-Chuang Kong, Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Quan Zhou, Ming-Jian Fei, Department of Pathology, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Author contributions: Chen J and Zhu MY were the patient’s surgeons, reviewed the literature and contributed to drafting the manuscript; Huang YH and Zhou ZC reviewed the literature and contributed to drafting the manuscript; Zhou Q and Fei MJ performed the pathological analyses and interpretation; and Shen YY and Kong FC revised the manuscript for important intellectual content. All authors issued final approval for the submitted version.
Supported by the Jiaxing Science and Technology Plan Project (Civil Science and Technology Innovation Project), No. 2019AY32028.
Informed consent statement: Written informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Yuan Zhu, MD, Attending Doctor, Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, No. 1518 Huancheng North Road, Jiaxing 314000, Zhejiang Province, China. hnzhumingyuan@163.com
Received: April 14, 2022
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
Processing time: 155 Days and 0.9 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

It is essential for clinicians and pathologists to maintain a high degree of suspicion while evaluating such synchronous cancers.

Keywords: Synchronous primary cancers; Gallbladder carcinoma; Duodenal papillary adenocarcinoma; Surgical treatment; Case report

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.