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A case of adenoid cystic carcinoma of the breast is reported. A 70-year-old woman was referred to our clinic with the chief complaint of right breast pain. The impression of the mass was chronic mastopathy, but a possible malignancy was suspected ultrasonographycally. Excisional biopsy and pathological examination revealed an adenoid cystic carcinoma. Patey operation was performed, no metastasis to axillary lymph node being found. Histologically, the tumor was characterized by “cysts” with a cribriform pattern. Histochemically, hyaline material inside “cysts” were alcian blue-positive and PAS-negative or weakly positive, and contents of the duct structures gave a positive reaction with PAS but negative with alcian blue. Immunohistochemically, CEA (carcinoembryonic antigen) and secretory component were disclosed in the duct structures, but none in the “cysts”.

A 52-year-old man visited our hospital, complaining of epigastric pain. ERCP, which was performed under a suspicion of acute pancreatitis due to his alcoholophilia, and gastrcendoscopy led to a preoperative diagnosis of synchronous early double carcinoma of the stomach and papilla of Vater. Pancreaticoduodenectomy was carried out. Carcinoma of the papilla of Vater was measured 1.1×1.0cm in size and histopathologically diagnosed as a moderatelly differentiated tubullar adenocarcinoma which slightly invaded the Oddi's muscle. Gastric cancer located on the gastric angle was 0.3×0.2cm in size. It was a well differentiated tubullar adenocarcinoma of type IIc limited to the mucosal layer. Any regional lymphnode metastasis was not found.

In 16 cases of abdominal aortic aneurysm (AAA) which we have treated surgically during the past two and half years, coincidental malignancy was encountered in four, i.e., three of gasric cancer and one of pulmonary cancer. The diagnosis of AAA and gastric or lung cancer was made simultaneously and preoperatively in cases 1, 2. AAA was diagnosed after 1.7 years and four years respectively, following the treatment of gastric cancer in cases 3 and 4. In case 1, gastric cancer with hemorrhagic complications was resected first, and aneurysmectomy was carried out on the 38th postoperative day. In case 2, a large AAA 6cm in size was wrapped first and a left upper lobectomy was done on the 19th postoperative day. In the other two patients, who were free of acertainable recurrence, aneurysmectomy was carried out in the early stage of gastric cancer in case 3, and wrapping was done in advanced gastric cancer in case.4. Case 2 died of myocardial infarction in third postoperative month. The other three patients are alive. In a patient with two life-threatening and separate diseases, surgical indications, method of the operation and priority of treatments should be carefully considered.