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Case Reports in Surgery
Volume 2016, Article ID 5650382, 3 pages
http://dx.doi.org/10.1155/2016/5650382
Case Report

Management and Reconstruction of a Gastroesophageal Junction Adenocarcinoma Patient Three Years after Pancreaticoduodenectomy: A Surgical Puzzle

Department of Oesophagogastric Surgery, St Thomas’ Hospital, King’s College London, London, UK

Received 12 June 2016; Accepted 3 August 2016

Academic Editor: Alexander R. Novotny

Copyright © 2016 Dionysios Dellaportas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. With the improving survival of cancer patients, the development of a secondary primary cancer is an increasingly common phenomenon. Extensive surgery during initial treatment may pose significant challenges to surgeons managing the second primary cancer. Case Presentation. A 69-year-old male, who had a pancreaticoduodenectomy three years ago for pancreatic head adenocarcinoma, underwent an uneventful extended total gastrectomy for gastroesophageal junctional adenocarcinoma. The reconstruction controversies and considerations are highlighted. Discussion. Genetic, environmental, and lifestyle factors are common for several gastrointestinal malignancies. However, the occurrence of a second unfavorable cancer such as gastroesophageal adenocarcinoma after pancreatic head cancer treatment is extremely uncommon. This clinical scenario possesses numerous difficulties for the surgeon, since surgical resection is the mainstay of treatment for both malignancies. Gastrointestinal reconstruction becomes challenging and requires careful planning and meticulous surgical technique along with sound intraoperative judgement.