Synchronous occurrence of gastrointestinal stromal tumor, pancreatic intraductal papillary mucinous neoplasm, and intrahepatic cholangiocarcinoma: Case report

Rationale: Gastrointestinal stromal tumor (GIST) is the most common primary mesenchymal tumors in gastrointestinal tract. Synchronous occurrence of GIST and tumors in other organs is rare. We first report an exceedingly rare case of synchronous occurrence of gastric GIST, pancreatic intraductal papillary mucinous neoplasm (IPMN) and intrahepatic cholangiocarcinoma. Patient concerns: A 70-year-old male presented to our hospital because of abdominal pain and dyspepsia. Tumor markers and liver function were abnormal. Abdomen computed tomography showed concurrent tumors in stomach, pancreas, and liver. Diagnosis: Pathology confirmed synchronous occurrence of gastric GIST, pancreatic IPMN and intrahepatic cholangiocarcinoma. Interventions: Mass excision, partly gastrectomy, wedge resection of VIII liver segments, and pancreatic-oduodenectomy were performed. Outcomes: During the 18-month follow-up, both laboratory tests and computed tomography examination revealed no sign of recurrence or metastasis. Currently, the patient is free of clinical symptoms such as abdominal discomfort, jaundice, and fever. Conclusion: As yet, no cases simultaneously with gastric GIST, pancreatic IPMN and intrahepatic cholangiocarcinoma have been described in literatures. This report increases the knowledge to avoid misdiagnosis and delayed therapy for coexistence of the described 3 types of neoplasm.