Two synchronous malignant tumors of the pancreas: a case report

Abstract

BackgroundOnly a limited number of multiple synchronous primary malignancies of the pancreas have been reported in the medical literature. We report a case of two solid malignant tumors of the pancreas diagnosed preoperatively.Case presentationWe describe a 65-year-old Sri Lankan woman who presented with progressive obstructive jaundice. Initial contrast-enhanced computed tomography imaging detected a malignant tumor at the tail of her pancreas. A second tumor of the pancreatic head was detected with integrated imaging using multidetector computed tomography and multimodal magnetic resonance imaging. She underwent total pancreaticoduodenectomy and splenectomy. Gross examination of the specimen confirmed the presence of two separate tumors. Histology of the ampullary tumor showed pancreatic-type adenocarcinoma and the tumor in the tail of her pancreas showed a colloid-type adenocarcinoma. ConclusionThe possibility of multiple primary malignant solid tumors of different types with malignant potential has to be considered even without background pathology when managing multiple tumors in the pancreas.

Diagnosis of synchronous pancreatic and ampullary adenocarcinomas during the COVID-19 pandemic

“…Multiple primary cancers are considered when each tumor is definitively malignant and they are primary tumors located distant from each other (2). To our knowledge, only two cases of pancreatic adenocarcinoma and a synchronic ampullary adenocarcinoma have been reported so far (1,3). The present case would be the third since it meets the proposed criteria, as both tumors were adenocarcinomas, located in different areas and the molecular analysis excluded the possibility metastasis.…”

Multifocal Primary Pancreatic Adenocarcinoma With No Precursor Lesion: A Report of Two Cases

“…Histological findings of multifocal adenocarcinoma usually reveals precancerous lesions (e.g., intraductal papillary mucinous neoplasms (IPMNs) [ 13 - 14 ] and pancreatic intraepithelial neoplasia (PanIN) [ 13 ]) giving chronic pancreatitis-like changes [ 13 - 14 ], but interestingly, in our two cases, there were no precancerous lesions identified. The pathogenesis of the multifocal pancreatic adenocarcinoma is still unknown.…”

Synchronous pancreatic tumors in a patient with history of Wilms tumor: A case of pancreatic adenocarcinoma and lipid‐rich neuroendocrine tumor diagnosed by cytopathology

“…In a study of pancreatic and periampullary collision cancers, 5 out of 10 cases were reported to have adenocarcinoma, only 2 of which were found within the pancreas . De Silva et al reported a case with an ampullary pancreatic‐type adenocarcinoma and a colloid‐type adenocarcinoma in the pancreatic tail . Cases of serous cystadenoma of the pancreas synchronous with adenocarcinoma have also been reported .…”

“…16 De Silva et al reported a case with an ampullary pancreatic-type adenocarcinoma and a colloid-type adenocarcinoma in the pancreatic tail. 23 Cases of serous cystadenoma of the pancreas synchronous with adenocarcinoma have also been reported. 21,24 Our case is among the few synchronous pancreatic tumors with adenocarcinoma and NET components.…”