2024 Volume 49 Issue 1 Pages 22-28
In a 74-year-old man, abdominal ultrasonography revealed the presence of a tumor, which was 15 mm in diameter and spanned the body and tail of the pancreas. An abdominal contrast-enhanced CT showed that the tumor was non-enhancing. Endoscopic ultrasound-fine needle aspiration of the tumor revealed a class III tumor. During the procedure, a poorly differentiated adenocarcinoma of the stomach was detected incidentally. In addition, colonoscopy revealed multiple adenomas, and the lesion in the transverse colon was diagnosed as poorly differentiated adenocarcinoma with submucosal invasion 2. The patient was diagnosed with pancreatic, gastric and transverse colon cancers and underwent distal pancreatectomy with splenectomy, distal gastrectomy, and transverse colectomy. The remnant gastric blood flow was evaluated using the intraoperative indocyanine green (ICG) fluorescence method. Pathologically, the pancreatic tumor was diagnosed as an invasive ductal carcinoma. In this report, we discuss a case in which a radical resection was performed for triple cancer of the pancreas, stomach, and transverse colon, preserving the stomach by intraoperative evaluation of remnant gastric blood flow using the ICG fluorescence method.
