TWO RESECTED CASES OF SYNCHRONOUS DOUBLE CANCER INCLUDING PANCREATIC CANCER

Recently two resected cases of synchronous double cancer including pancreatic cancer were experiences. Case 1: A 51-year-old man was admitted because of jaundice. Laboratory data: T. bil 20.3mg/dl, D. bil 9.7mg/dl, CEA 6.9ng/ml, CA19-9 84U/ml, Dupan-2 470U/ml and blood occult (2+). PTCD showed a stenosis of the lower common bile duct and colonofiber showed a tumor of the rectum, which was diagnosed as adenocarcinoma histologically. Pancreatoduodenectomy and low anterior resection were carried out simultaneously. The tumor of the pancreas was a a 1.5×1.5cm, moderately differentiated tubular adenocarcinoma. Metastasis of superior posterior pancreaticoduodenal lymph node was positive. Case 2: A 75-year-old man was admitted because of epigastralgia and weight loss. Laboratory data: serum AMY 2400U/L, CEA 7.2ng/ml, CA19-9 2400U/ml and blood occult (1+). Abdominal CT showed a tumor of the body and tail of the pancreas and endoscopy showed a small depressed lesion, which was diagnosed as squamous cell carcinoma histologically, in the middle thoracic esophagus. distal pancreatectomy and resection of the intrathoracic esophagus were carried out simultaneously. The tumor of the pancreas was 4×3cm, moderately differentiated tubular adenocarcinoma, and exposed to pancreatic capsule remarkably. Lymph node metastasis was negative. Two of all 30 cases of pancretic cancer were diagnosed as synchronous double cancer in the hospital and blood occult was useful for examining the alimentary tract.