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Abdominal CT finding. An about 3 cm sized intraluminal enhancing mass was seen on the rectosigmoid junction without streaky densities in surrounding pericolic fat tissue.
Source publication
Collision tumors of the colon are rare. A 54-year-old man was referred to our hospital for the evaluation of hematochezia. Colonoscopy demonstrated the presence of about 3 cm sized mass in the rectosigmoid junction. After surgical resection, the colonic lesion was histologically composed of two discrete lesions: adenocarcinoma in the superficial la...
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Objectives:
To correlate imaging parameters from baseline magnetic resonance imaging (MRI)-diffusion-weighted imaging (DWI) and -2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) with synchronous and metachronous metastases in mucinous (MC) and nonmucinous (NMC) rectal cancer.
Methods:
111 patients with e...
Citations
... Thus, the "collision tumors" are morphologically neighborhood synchronous neoplasm that developed every other territories and developed latero-lateral in the same organ. Without special or unique clinical features, these tumors are difficult to diagnose preoperatively, as in the case presented by us who presented with clinical manifestation of intestinal obstruction and pathological identification of these components is often the only way dual to make a diagnosis [32]. Milne et al. (2004) conducted a molecular analysis of the existence of collision tumors in gastro-esophageal junction and concluded that the diagnosis of these neoplasms has no molecular basis [33]. ...
Collision tumors of the colon are rare. A 64-year-old man was referred on Emergency County Hospital, Craiova, Romania for the evaluation of intestinal obstruction. Colonoscopy demonstrates the presence of about 9÷5 cm sized mass in the rectosigmoid junction. After surgical resection, the rectosigmoid lesion was histopathologically composed of two distinct lesions: mucoid adenocarcinoma in the superficial layer and poorly differentiated neuroendocrin carcinoma in the deeper layer. A rectosigmoid tumor showed two distinct tumors with no admixture or transposition of two neoplastic components. A lymph node metastatic deposit contained both tumors. Immunohistochemical stainings were consistent with mucinous adenocarcinoma and neuroendocrine carcinoma of the two neoplasms. We report this case of colonic collision tumor (mucoid adenocarcinoma and neuroendocrine carcinoma) and review of the literature.
Background:
Colorectal neuroendocrine carcinoma (NEC) is a rare tumor that demonstrates aggressive growth pattern with ingrowth into the tract, metastasis to the other organs, and invasion to the surrounding organs; these clinical characteristics result in poor prognosis. Surgical resection appears as an effective approach; however, because it is difficult to accurately diagnose NEC during the early stage and owing to its aggressive growth pattern, development of a reliable standard chemotherapy regimen and management strategies are essential.
Case summary:
Here, we report the case of patient with NEC showing an aggressive growth pattern that resulted in the rupture of the tumor to the outside the colon after stenting of the internal colonic stenosis. In addition, the tumor invaded into the duodenum, thereby causing duodenal stenosis that required an additional stent in the duodenum. This aggressive growth pattern is one of the main features of the NEC that is different from adenocarcinoma. To clarify the clinical characteristics, we reviewed 60 recently reported cases, including data on tumor location, size, treatment, and prognosis.
Conclusion:
We consider that the information presented here is of great significance for the diagnosis, treatment, and management of symptoms of the patients with NEC.
Neuroendocrine carcinoma of colon is a rare disease entity that is histologically poorly differentiated and immunochemically synaptophysin positive, enabling it to be confirmed by an immunohistochemical stain. Neuroendocrine carcinomas, in almost all cases, have poor prognosis due to a tendency of early metastasis and lack of standardized treatment. The concurrent diagnosis of neuroendocrine carcinoma and adenocarcinoma is extremely rare. The relation of these two disease entities is not understood. We experienced a patient with a colonic neuroendocrine carcinoma concurrent with adenocarcinoma. A 65-year-old male presented with abdominal pain. Emergent computed tomography suggested a malignant tumor of the ascending colon. Colonoscopy showed an infiltrative lesion in the ascending colon with a luminal narrowing, a large pedunculated lesion at the splenic flexure, and multiple small polyps in the descending colon. The patient underwent a right hemicolectomy including the pedunculated lesion. The pathology confirmed advanced neuroendocrine carcinoma in the ascending colon, adenocarcinoma in proximal descending colon, and multiple metastatic lymph nodes of neuroendocrine carcinomas on abdomen. The patient underwent the postoperative chemotherapy but did not tolerate it well and expired a year after diagnosis. We report this rare case with a review of the literature.
Collision tumors, characterized by the coexistence of phenotypically and genotypically distinct tumors at the same site, are distinctly rare in the genitourinary tract and pose a diagnostic challenge. The goal of this study is to present a series of such cases from a single institution highlighting the unusual clinicopathologic features of these tumors.
Six cases were retrospectively identified from our surgical pathology files and included internal and consultation cases (2006-2012). All tumors were identified by H&E and selected immunohistochemistry.
There were 5 males and 1 female patients ranging in age from 57-84 years (average 73 years). The sites of these collision tumors were located in the kidney (3 cases), bladder (2 cases), and prostate. All collision tumors involved at least one malignant neoplasm.
The diagnosis of collision tumors in the genitourinary tract is a perplexing task. Awareness of these rare entities, thorough sampling of the tumor mass, and appropriate use of ancillary techniques to demonstrate the different tumor components can help avoid an incorrect diagnosis, as well as with pathologic staging.
