[Case of simultaneous triple cancers of the duodenal papilla, gallbladder and stomach].

The patient was a 76-year-old man with simultaneous triple cancer arising in the duodenal papilla, gallbladder and stomach, whose complaint was epigastralgia. Endoscopic and radiologic studies revealed early gastric cancer (IIc) at the posterior wall of the antrum; ERCP disclosed obstruction with "apple core" appearance in the distal bile duct. Pancreaticoduodenectomy, cholecystectomy and distal gastrectomy with lymph node dissection were performed. Histopathological examination of the resected specimens revealed papillo-tubular adenocarcinoma in the duodenal papilla, well differetiated tubular adenocarcinoma in the gallbladder, and moderately differentiated tubular adenocarcinoma in the gastric mucosa.