ABSTRACT
Patients with early gastric cancer (EGC) may be associated with an increased risk of having a second primary cancer. Metachronous primary malignancies may have an influence on the long term prognosis of these patients. We report here on two cases of bile duct cancer after performing subtotal gastrectomy for EGC. A 59-year-old man underwent pylorus preserving pancreaticoduodenectomy (PPPD) under the diagnosis of bile duct cancer, and this was done 5 years after he had undergone gastrectomy. The pathological specimens were different between the EGC and bile duct cancer according to their morphology and immunohistochemical staining, and this case was determined to be metachronous double cancer. The second case was a 39-year-old man who received PPPD for bile duct cancer 4 years after undergoing gastrectomy. Double primary malignancies of bile duct cancer and gastric cancer are very rare.