Abstract
A 68-year-old man with primary lung adenocarcinoma was admitted to our hospital because of double tumors in the pancreatic head and body. Diagnosis was not possible, but we performed ERCP and EUS. Although these tumors were identified as adenocarcinoma on endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), it was difficult to histopathologically confirm whether they were primary tumors or metastases. In addition, TTF-1 immunohistochemical staining demonstrated that the staining pattern of the pancreatic double tumors was different from that of the lung cancer. The lung cancer was TTF-1-positive, but the pancreatic cancers were TTF-1-negative. Therefore, our diagnosis was primary lung cancer and synchronous double invasive ductal carcinomas of the pancreas. The patient underwent total pancreatectomy and right upper video-assisted thoracoscopic lobectomy. The diagnosis based on the post-operative pathological findings was the same. Herein, we report an important case in which we diagnosed triple cancers in the lung and pancreas pre-operatively, and we note that multiple pancreatic cancers are rare.
