• QunGuang Jiang, TaiYuan Li, DongNing Liu, and Cheng Tang.
• The First Affiliated Hospital of NanChang University, Gastrointestinal Surgery, NanChang, China.
• Medicine (Baltimore). 2018 May 1; 97 (19): e0540.

RationaleSynchronous double malignancies, including carcinoma of the ampulla of Vater and rectal carcinoma, are generally uncommon occurrences in the gastrointestinal tract.Patient ConcernsThe present study report a case of a 37-year-old man who was incidentally found to suffer from carcinoma of the ampulla of Vater and rectal carcinoma.DiagnosesThe duodenoscopy was performed and revealed an ulcerated and bulky ampulla of Vater, the biopsy from which revealed a moderate-differentiated adenocarcinoma, A local hospital colonoscopy confirmed a tumor located in rectal 7 cm from the anal margin and biopsy-confirmed poorly differentiated adenocarcinoma.InterventionsAbout such patient treatment, both open and laparoscopic surgery are restricted because of operation complexity, large injury, and poor cosmetic effect. surgery performed using Da Vinci robotic surgical system (DVSS).OutcomesNo evidence of recurrence or relapses was found in the first year after surgery.LessonsAlthough sporadic double malignancies are uncommon, they should be considered when evaluating cancer patients. Complex surgery performed by robotic surgery may became surgeon's preferred treatment modality.

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