Department of Surgery, Omori Red Cross Hospital, 4-30-11 Chuo, Ota-ku, Tokyo 143-8527, Japan.
Surg Today. 2010 Oct;40(10):975-81. doi: 10.1007/s00595-009-4166-7. Epub 2010 Sep 25.
This report presents the case of a 62-year-old man with a collision tumor of primary malignant lymphoma and adenocarcinoma in the cecum. All regional mesenteric lymph nodes that were removed surgically were found to be occupied by lymphoma cells and no lymph nodes contained any cancer cells, although the primary carcinomas did exhibit lymphatic invasion. Malignant lymphoma was also seen in the duodenum. Systemic chemotherapy was administered for the malignant lymphoma, and a complete response was thus obtained. However, just after chemotherapy multiple liver metastases of adenocarcinoma emerged, and chemotherapy against adenocarcinoma was therefore continued. The occurrence of synchronous lymphoma and adenocarcinoma of the colorectum is rare. Furthermore, collisions of these different entities are also extremely unusual; so far only five such case reports have been published. The accurate clinical determination of the dominant tumor and a close follow-up is required for proper treatment in these cases.
本报告介绍了一例 62 岁男性患者,其盲肠中发生原发性恶性淋巴瘤和腺癌碰撞肿瘤。所有手术切除的区域性肠系膜淋巴结均被淋巴瘤细胞占据,尽管原发性癌确实存在淋巴浸润,但没有淋巴结含有任何癌细胞。十二指肠中也可见恶性淋巴瘤。对恶性淋巴瘤进行了全身化疗,因此获得了完全缓解。然而,就在化疗后,出现了多个肝转移的腺癌,因此继续对腺癌进行化疗。结直肠同时发生淋巴瘤和腺癌的情况很少见。此外,这些不同实体的碰撞也极为罕见;到目前为止,仅发表了五例此类病例报告。在这些情况下,需要准确的临床确定优势肿瘤,并密切随访,以便进行适当的治疗。