Triple synchronous tumors: gastric, gallbladder, and sigmoid adenocarcinoma case report

Öz

In this case report a patient with triple synchronous tumors: gastric adenocarcinoma, gallbladder adenocarcinoma, and adenocarcinoma of the sigmoid colon has been presented. An 86-year-old female patient with a history of weight loss and epigastric pain was admitted to our department. Her upper gastrointestinal endoscopy and colonoscopy showed a 2 cm-sized polypoid mass in the posterior wall of the gastric antrum and a 3,5 cm-sized tumor in the sigmoid colon. A third tumor was detected in the gallbladder by ultrasonography and tomography. In the same operation, all tumors were removed by sigmoid colon resection, cholecystectomy, and subtotal gastrectomy. Stages of tumors were for gastric adenocarcinoma (pT1N0), gallbladder adenocarcinoma (pT1N0), and sigmoid adenocarcinoma (pT4N0). 14 months after surgery the patient was re-operated due to ileus caused by recurrence of colonic tumor. Left hemicolectomy, partial resection for adhesion of the small intestine, and side-by-side anastomosis were performed. In the intensive care unit, the patient died of cerebrovascular incident after 4th day of surgery. The chance of finding multiple primary malignancies should always be thought of throughout the treatment and follow-up of elderly cancer patients. The physician should be alert to the possibility of their occurrence to achieve proper treatment.

Anahtar Kelimeler

• Synchronized triple tumor
• multiple primary cancer
• adenocarcinoma

Üçlü senkron tümörler: mide, safra kesesi ve sigmoid adenokarsinom olgu sunumu

Öz

Bu olgu sunumunda, gastrik adenokarsinom, safra kesesi adenokarsinomu ve sigmoid kolon adenokarsinomu olmak üzere üçlü senkron tümörü olan bir hasta incelenmiştir. Kliniğimize kilo kaybı ve epigastrik ağrı öyküsü olan 86 yaşında kadın hasta başvurdu. Üst gastrointestinal sistem endoskopisi ve kolonoskopisinde mide antrum arka duvarında 2 cm büyüklüğünde polipoid kitle ve sigmoid kolonda 3,5 cm büyüklüğünde tümör saptandı. Ultrasonografi ve tomografi ile safra kesesinde üçüncü bir tümör tespit edildi. Aynı ameliyatta sigmoid kolon rezeksiyonu, kolesistektomi ve subtotal gastrektomi ile tüm tümörler çıkarıldı. Tümörlerin evreleri mide adenokarsinomu (pT1N0), safra kesesi adenokarsinomu (pT1N0) ve sigmoid adenokarsinom (pT4N0) idi. Ameliyattan 14 ay sonra hasta, kolon tümörünün nüksü sonucu oluşan ileus nedeniyle tekrar ameliyat edildi. Sol hemikolektomi, ince barsak adezyonu için parsiyel rezeksiyon ve yan yana anastomoz yapıldı. Yoğun bakım ünitesinde yatan hasta ameliyat sonrası 4. gününde serebrovasküler olay sonucu kaybedildi. Yaşlı kanser hastalarının tedavi ve izlemi boyunca birden fazla primer malignite bulma şansı her zaman düşünülmelidir. Uygun tedaviyi elde etmek için mutiple kanserin ortaya çıkma olasılıklarına karşı uyanık olunmalıdır.

Anahtar Kelimeler

• Üçlü senkronize tümör
• multipl primer kanser
• adenokarsinom

Etik Beyan

Helsinki kriterlerine uygun hasta onamı alınarak olgu sunumu yapılmıştır

Kaynakça

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