A Case of Triple Cancer in the Digestive Organs

Here, we report a case of triple compound cancer consisting of superficial esophageal carcinoma, early gastric cancer and cholangiocarcinoma in an 84-year-old man. In October 1993, upper gastrointestinal endoscopy revealed a superficial esophageal carcinoma (0-IIa), which was left untreated. In September 1995, the patient developed jaundice, and a common bile duct carcinoma was diagnosed by endoscopic retrograde cholangiopancreatography (ERCP). Meanwhile, early gastric cancer (O'-IIa) was diagnosed, which proved histopathologically to be a well-differentiated adenocarcinoma. The superficial esophageal cancer developed into 0-IIa+IIb, and histological studies indicated squamous cell carcinoma. Therefore, we diagnosed this as a case of metachronous triple compound cancer. The patient and his family requested therapy for jaundice reduction only, which was achieved by placement of a transnasal bile duct drainage tube and a metal stent (Wall stent). Subsequently, the jaundice was reduced, and he was discharged from our hospital in good condition. He is now well 5 months after the therapy. The incidence of triple cancer has increased recently, and clinical attention to this phenomenon is necessary. Previous reports stated that esophageal cancer is commonly the primary cancer and that associated secondary cancers develop in the stomach, colon, and/or lung. Therefore, thorough examination of these organs is essential when an esophageal cancer is detected, as in our case.

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