A case of quadruple cancer including synchronous multiple primary lung cancers with colon cancer and cholangiocarcinoma

Abstract

We herein report a rare surgical case of quadruple cancer including synchronous multiple primary lung cancers, colon cancer, and cholangiocarcinoma. To our knowledge, this is the first report in Japan. A 76-year-old man, with a history of endoscopic resection of colon cancer, was incidentally diagnosed with lung neoplasms. Chest computed tomography revealed two nodules in the right upper lung. No other extrapulmonary metastatic lesions were present. With a diagnosis of lung cancer after transbronchial lung biopsy, we performed right upper lobectomy with lymph node dissection. The nodules were pathologically diagnosed as synchronous multiple primary lung cancers that had different histological types: adenocarcinoma and squamous cell carcinoma. Seven months later, he developed jaundice and was diagnosed with bile duct stricture due to cholangiocarcinoma with endoscopic retrograde cholangiopancreatography. After the endoscopic procedure, acute pancreatitis occurred, and he died one month later. The prognosis of patients with multiple cancers is basically poor, so it is important to perform close follow-up before and after surgery with collaboration among specialists in other fields.