Collision tumors in the gastrointestinal tract: a rare case series

Bhattacharya, Aruna; Saha, Rajesh; Biswas, Jayanta Kumar; Biswas, Jhuma; Ghosh, Bikash Chandra

doi:10.2147/imcrj.s35818

Cited by 13 publications

(11 citation statements)

References 17 publications

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“…The vast majority of the cases (90%) in our review underwent gastrectomy (total or Given their rare nature, it is challenging to determine the behavior of CTs, but it is suggested that they have a greater risk for metastasis (42). Moreover, in adenocarcinoid CT, their progression seems to depend on the glandular component (9). Available data on their behavior are too limited to be able to reach safe conclusions.…”

Section: Discussionmentioning

confidence: 94%

Collision Tumors of the Gastrointestinal Tract: A Systematic Review of the Literature

et al. 2018

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Background/Aim: Collision tumors are rare neoplasms which consist of two or more distinct neoplasms that develop adjacent to one another and coexist with no or minimal intermingling between them. Their diagnosis is often incidental and their behavior remains widely unknown. Several theories have been proposed regarding their pathogenesis. The objective of this study was the evaluation of current evidence on collision tumors of the gastrointestinal tract regarding their pathology, biological behavior and treatment approach. Materials and Methods: The PubMed and Cochrane bibliographical databases were searched from January 1997 to July 2018 (last search: July 5th, 2018) for studies reporting on collision tumors of the gastrointestinal tract that also included a therapeutic approach. Results: Forty-seven studies reporting on collision tumors of the gastrointestinal tract were identified. They reported collectively on 53 cases (43 males, 10 females) with collision tumors of the esophagus, stomach, small intestine and large intestine. The vast majority (96.2%) of tumors consisted of two distinct histological components and only two cases involved a greater number of histological subtypes. Fifty-one patients underwent a surgical or endoscopic tumor resection, accompanied in 22 cases by adjuvant or neoadjuvant therapy. The remaining two patients underwent palliative operations. In total, three patients experienced immediate postoperative complications. Conclusion: Collision tumors of the gastrointestinal tract, despite their rare nature, constitute a quite interesting field of study. This review offers a thorough insight into the clinicopathological characteristics and biological behavior of these rare tumors.

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Section: Discussionmentioning

confidence: 94%

Collision Tumors of the Gastrointestinal Tract: A Systematic Review of the Literature

et al. 2018

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“…Adenocarcinoma is the most common colonic malignancy but only presents with synchronous or metachronous tumors in 5% of cases. 5 , 6 In contrast, colorectal lymphoma is extremely infrequent, representing <0.5% of all primary CRC. 4 The clinical presentation of collision tumors is not specific and depends primarily on the affected organ.…”

Section: Discussionmentioning

confidence: 99%

“… 5 One hypothesis suggests that tumors arise in continuity through an accidental event and that the presence of one tumor precipitates the adjacent tumor by altering the microenvironment. 4 , 6 A lymphomatous process may be the initial event, compromising the patient’s immune system. 4 Nonetheless, there is no evidence that immunodeficiency induces activation of oncogenes or inactivation of tumor-suppressor genes.…”

Section: Discussionmentioning

confidence: 99%

Conundrum of a Large Bowel Neoplasm: Collision Tumor

Soto

Vazquez

Grigg-Gutierrez

et al. 2018

ACG Case Reports Journal

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A 79-year-old Hispanic man was admitted to the intensive care unit with symptomatic iron-deficiency anemia and watery diarrhea. Radiological images revealed diffuse colonic wall thickening, a soft-tissue fullness in the ascending colon, and multiple mesenteric lymphadenopathies. Colonoscopy showed multiple aphthous ulcers throughout the colon and a large deep ulcer with irregular raised borders in the rectosigmoid area. Histological exam of the ulcers showed severe ulcerative colitis, while biopsy of the deep ulcer revealed a well-differentiated adenocarcinoma. Colectomy specimen was consistent with colliding diffuse large B-cell lymphoma and adenocarcinoma.

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“…A number of neuroendocrine cells are often present inside gastric adenocarcinomas [ 28 ] while neuroendocrine carcinomas are often accompanied by gastric adenocarcinomas in other parts of gastrointestinal track [ 21 ]. It has been estimated that a neuroendocrine tumor can coexist with gastric adenocarcinoma in 0.4–4.3% of all cases [ 29 ]. Close association of these tumor types has created the concept of Mixed Endocrine Exocrine Carcinomas (MEECs) [ 30 ].…”

Section: Methodsmentioning

confidence: 99%

Gastric Collision Tumors: An Insight into Their Origin and Clinical Significance

Michalinos

Constantinidou

Kontos

2015

Gastroenterology Research and Practice

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Collision tumors are rare neoplasms displaying two distinct cell populations developing in juxtaposition to one another without areas of intermingling. They are rare entities with only 63 cases described in English literature. Tumors encountered are gastric adenocarcinomas colliding with lymphomas, gastrointestinal stromal tumors, squamous cell carcinomas, and neuroendocrine tumors. Their cell origin is obsolete by the time of diagnosis. Different tumorigenesis theories have been suggested to explain their behavior, yet none has managed to provide satisfactory explanation for all cases. Clinically they are indistinguishable from the dominant tumor. Lack of data does not allow detailed assessment of their behavior yet they seem aggressive neoplasms with dismal prognosis. The majority of cases have been diagnosed postoperatively during histologic examination of specimens. There are no guidelines or concrete evidence to support best way of adjuvant or other types of treatment. However, these rare neoplasms might help in unlocking secrets of cancer behavior including tumorigenesis, differentiation, and adhesion and thus clinicians should be aware of their existence.

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Collision tumors in the gastrointestinal tract: a rare case series

Cited by 13 publications

References 17 publications

Collision Tumors of the Gastrointestinal Tract: A Systematic Review of the Literature

Collision Tumors of the Gastrointestinal Tract: A Systematic Review of the Literature

Conundrum of a Large Bowel Neoplasm: Collision Tumor

Gastric Collision Tumors: An Insight into Their Origin and Clinical Significance

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