DOUBLE CANCER IN A 74-YEAR-OLD WOMAN - A CASE-REPORT WITH GENETIC FINDINGS

An autopsy case of double cancer is reported. The patient had undergon e right hemicolectomy for colon carcinoma in 1982, and the second canc er was detected in the pancreas in April 1989, which was diagnosed as intraductal papillary adenocarcinoma that is known for its favorable p rognosis after surgical resection. However, as the patient did not con sent to the operation, she died in August 1994, five years after the d iagnosis of the second cancer. Histopathological study revealed neithe r recurrence nor metastasis of colon carcinoma pancreatic carcinoma me tastasized to the lung, liver, and peritoneum. DNAs mere extracted fro m paraffin-embedded tissue for molecular pathological examinations. Di fferent mutations were found at codon 12 of the R-ras gene by nucleoti de sequencing analysis: one in the colon and the other in the pancreas and lung. Over-expression of p53 protein was also detected in the col on by immunostaining. Replication error was not observed in these thre e tumors suggesting that a factor(s) other than genetic instability wa s playing a role in the development of double cancer in this patient.