Collision tumor consisting of primary follicular lymphoma and adenocarcinoma in the cecum: A case report and literature review

Abstract

The present study reports the case of a collision tumor consisting of follicular lymphoma (FL) and adenocarcinoma in the cecum of a 73-year-old man. To the best of our knowledge, the present study is the 11th case of a collision tumor consisting of colon adenocarcinoma and lymphoma to be reported in the literature, and the first case of cecum adenocarcinoma with low grade FL in the same segment of the cecum and the same regional lymph node to be reported. The present study reviewed the literature to determine treatment options for patients with collision tumors. The present patient was administered with adjuvant chemotherapy for T3N1M0 colon cancer following surgery, due to the dominance of colon adenocarcinoma in the collision tumor. Following the completion of treatment, progression of the untreated FL was observed. In the literature, patients with collision tumors are administered with chemotherapy for stage IV FL, and following the completion of treatment patients have presented with a recurrence of early stage colon adenocarcinoma. The recommended treatment for collision tumors is dependent on the dominant tumor; however, the treatment options for collision tumors in the literature appeared to exacerbate the other tumor. The characteristics of the tumors altered following chemotherapy, and immunological alterations in the tumors due to chemotherapy appear to have contributed to the exacerbation of the tumors. Therefore, patients with early-stage tumors should be considered at risk of recurrence of other malignancies, which are present in collision tumors.

Tiny but Mighty: Collision Tumor of a Superficial Adenocarcinoma Arising From a Tubulovillous Adenoma with Associated Low-Grade Follicular Lymphoma

“…Whether there are adverse implications of a lymphoma/colorectal adenocarcinoma collision tumor, compared with the individual prognoses of the 2 conditions, are unknown given the rarity of cases. [14][15][16][17][18][19][20][21] In one previously reported case, the initially staged Ann Arbour 1EA follicular lymphoma progressed after surgery and adjuvant chemoradiotherapy for the colorectal adenocarcinoma. A further course of chemotherapy after progression of the lymphoma was noted, but the patient died subsequently.…”

Collision Tumor Comprising Primary Malignant Lymphoma and Adenocarcinoma in the Ascending Colon

“…Collision tumors comprising colorectal adenocarcinoma and lymphoma are extremely rare, and only a few cases have been reported in the literature. A search for case reports published from April 2004 to December 2019 in the Japan Medical Abstracts Society and PubMed databases using the keywords "collision tumor," "adenocarcinoma in the colon," and "malignant lymphoma" yielded reports of 14 cases, including the present one (Table 2) [3][4][5][6][7][8][9][10][11][12][13][14][15].…”

Collision Tumor Composed of an Inflammatory Myofibroblastic Tumor and Adenocarcinoma of the Colon: a Rare Entity

“…Collision of the two malignancies can occur between tumors originating in the same organ or between metastases from other sites [4]. In literature, collision tumors of the colon consist of a combination of adenoma or adenocarcinoma with lymphoma, neuroendocrine tumors or leiomyosarcoma [1][2][3]. To the best of our knowledge, this is the first case of a colon collision tumor composed of adenocarcinoma and IMT.…”

“…In literature, collision tumors which have occurred in the colon consist of a combination of adenoma or adenocarcinoma with lymphoma, neuroendocrine tumors or leiomyosarcoma [1][2][3]. Here, we report the first case of a collision tumor composed of colon adenocarcinoma and an inflammatory myofibroblastic tumor (IMT).…”