A Case of Curative Resected Triple Cancers: Intraductal Papillary-Mucinous Carcinoma in the Pancreatic Head; Cancer in the Lower Part of the Bile Duct; and Gall Bladder Cancer after Repeated Episodes of Pancreatitis and Cholangitis

Abstract

An 82-year-old-man, with a history of repeated episodes of chronic pancreatitis and cholangitis, was admitted to our hospital due to fever and abdominal pain. A diagnosis of pancreatitis and cholangitis was made. Furthermore, intraductal papillary-mucinous carcinoma (IPMC) in the pancreatic head and cancer in the lower part of the bile duct was detected by CT and ERCP. Pylorus-preserving-pancreaticoduodenectomy was performed. Gall bladder cancer was also observed in the removed specimen. Triple cancers with IPMC, bile duct cancer and gall bladder cancer were finally diagnosed after surgery and this combination has never been previously reported. It is well known that intraductal papillary-mucinous neoplasm (IPMN) induces other malignant neoplasms, but the origin is unclear. In this case, a history of repeated pancreatitis and cholangitis may have significantly affected the overlapped carcinogenesis.