Abstract
A 40 year-old woman entired with a compliment of severe e p igastralgia and marked elevation of serum amylase. Ultrasonography (US) as well as computer tomography (CT) revealed polypoid tumor in bladder, and ERCP, anomalous arrangement of pancreatobiliary ductal system(APBD). According to clinical diagnosis of gallbladder cancer associated with APBD, radical cholecystectomy performed. Two years after the operation, she began to complain of abdominal back pain, and pancreatic body to tail tumor was discovered by abdominal US, CT and ERCP. The second laparotomy was performed to extract the tumor. Histopathologically both tumor showed same papillotubular adenocarcinoma, without any invasive proliferation in the first gallbladder carcinoma. In the later pancreatic lesion, epithelial malignancy was present in main pancreatic duct with partial invasion into pancreatic parenchyma. Addition to epithelial malignancy, some small endocrine adenomas showing immunocytochemical positivity to glucagon. This rare case with double cancer may suggest the risk factor, induced by the condition of APBD, acts on the carcinogenesis on pan creatic duct as well as biliary duct system.
