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We report the case of a triple synchronous cancer of 3 distinct location: gallbladder, common bile duct (CBD) and papilla of Vater.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>An 84-years-old woman, was admitted to our Hospital with clinics features of obstructive jaundice.<\/jats:p>\n                    <jats:p>Dilatation of the biliary tree and CBD without evidence of gallstones was seen at US. CT scan confirmed distal CBD obstruction.<\/jats:p>\n                    <jats:p>\n                      An\n                      <jats:italic toggle=\"yes\">endo<\/jats:italic>\n                      -US showed a nodule of the head of pancreas infiltrating the lower CBD.\n                    <\/jats:p>\n                    <jats:p>Finally, hepatic-MRI displayed a gallbladder malignancy with invasion of CBD.<\/jats:p>\n                    <jats:p>\n                      Preoperative staging showed 3 diagnostic suspicions: carcinoma of CBD on CT, pancreatic carcinoma on\n                      <jats:italic toggle=\"yes\">endo<\/jats:italic>\n                      -US and malignancy of gallbladder on MRI.\n                    <\/jats:p>\n                    <jats:p>A cephalic duodenopancreatectomy and radical gallbladder resection was performed.<\/jats:p>\n                    <jats:p>Final pathology revealed 3 distinct location of moderately differentiated adenocarcinomas: Gallbladder, CBD and Vater's papilla.<\/jats:p>\n                    <jats:p>Microscopic examination didn't detect any direct continuity between the 3 tumors. Metastases were identified in the pancreaticoduodenal, peri-hepatic and peri-gastric lymph nodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion<\/jats:title>\n                    <jats:p>Literature displayed 22 cases of synchronous malignancies of gallbladder and CBD and 1 case of triple cancer with associated Vater's papilla carcinoma.<\/jats:p>\n                    <jats:p>In most of these cases, an association with an anomalous pancreatic-bile duct junction was reported.<\/jats:p>\n                    <jats:p>Although the real incidence remain unknown, it was reported to occur in 5\u201310% of CBD cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Suspicion of such combination of cancer should be remembered, especially when preoperative investigations don't allow a precise localization of tumor in the biliary tree.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2021.106469","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:44:46Z","timestamp":1633653886000},"page":"106469","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Triple cancer of gallbladder, common bile duct and papilla of Vater"],"prefix":"10.1097","volume":"89","author":[{"given":"Stefano","family":"Passoni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takamune","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilie","family":"Uldry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Melloul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nermin","family":"Halkic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Cristaudi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-2-20260114","first-page":"651","article-title":"Double cancer of the gallbladder and common bile duct associated with an anomalous pancreaticobiliary ductal junction without a choledochal cyst: report of case","volume":"29","author":"Suzuki","year":"1999","journal-title":"Jpn. 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