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Abdominal Radiology

, Volume 42, Issue 12, pp 2909–2926 | Cite as

Collision and composite tumors; radiologic and pathologic correlation

  • Calvin T. Sung
  • Anup Shetty
  • Christine O. Menias
  • Roozbeh Houshyar
  • Shreya Chatterjee
  • Thomas K. Lee
  • Paul Tung
  • Mohammed Helmy
  • Chandana Lall
Invited article

Abstract

The terms composite and collision tumors have been used interchangeably throughout radiological literature. Both composite and collision tumors involve two morphologically and immunohistochemically distinct neoplasms coexisting within a single organ. However, collision tumors lack the histological cellular intermingling seen in composite tumors. Composite tumors often arise from a common driver mutation that induces a divergent histology from a common neoplastic source while collision tumors may arise from coincidental neoplastic change. The purpose of this review is to provide an overview of abdominal composite and collision tumors by discussing hallmark radiographic and pathological presentations of rare hepatic, renal, and adrenal case studies. A better understanding of the presentation of each lesion is imperative for proper recognition, diagnosis, and management of these unique tumor presentations.

Keywords

Biphenotypic Composite hepatocellular and cholangiocarcinoma Live collision Composite renal cell carcinoma Collision cholangiocarcinoma Renal collision Adrenal collision 

Notes

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Otal P, et al. (1999) Imaging Features of Uncommon Adrenal Masses with Histopathologic Correlation1. http://dx.doi.org/10.1148/radiographics.19.3.g99ma07569.
  2. 2.
    Nayyar M, et al. (2014) Composite liver tumors: a radiologic-pathologic correlation. Clin Mol Hepatol 20(4):406–410CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Michalinos A, Constantinidou A, Kontos M (2015) Gastric collision tumors: an insight into their origin and clinical significance. Gastroenterol Res Pract 2015:314158CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Aggarwal N, et al. (2012) Tumor-to-tumor metastasis: case report of a pulmonary adenocarcinoma metastatic to a clear cell renal cell carcinoma. Pathol Res Pract 208(1):50–52CrossRefPubMedGoogle Scholar
  5. 5.
    Anani W, et al. (2014) A series of collision tumors in the genitourinary tract with a review of the literature. Pathol Res Pract 210(4):217–223CrossRefPubMedGoogle Scholar
  6. 6.
    Yao B, et al. (2015) A collision tumor of esophagus. Int J Clin Exp Pathol 8(11):15143–15146PubMedPubMedCentralGoogle Scholar
  7. 7.
    Brandwein-Gensler M, Urken M, Wang B (2004) Collision tumor of the thyroid: a case report of metastatic liposarcoma plus papillary thyroid carcinoma. Head Neck 26(7):637–641CrossRefPubMedGoogle Scholar
  8. 8.
    Chin S, Kim Z (2014) Sarcomatoid combined hepatocellular-cholangiocarcinoma: a case report and review of literature. Int J Clin Exp Pathol 7(11):8290–8294PubMedPubMedCentralGoogle Scholar
  9. 9.
    Shetty AS, et al. (2014) Combined hepatocellular-cholangiocarcinoma: what the radiologist needs to know about biphenotypic liver carcinoma. Abdom Imaging 39(2):310–322CrossRefPubMedGoogle Scholar
  10. 10.
    Jarnagin WR, et al. (2002) Combined hepatocellular and cholangiocarcinoma: demographic, clinical, and prognostic factors. Cancer 94(7):2040–2046CrossRefPubMedGoogle Scholar
  11. 11.
    Lee SD, et al. (2014) Clinicopathological features and prognosis of combined hepatocellular carcinoma and cholangiocarcinoma after surgery. Hepatobiliary Pancreat Dis Int 13(6):594–601CrossRefPubMedGoogle Scholar
  12. 12.
    Lee JH, et al. (2011) Long-term prognosis of combined hepatocellular and cholangiocarcinoma after curative resection comparison with hepatocellular carcinoma and cholangiocarcinoma. J Clin Gastroenterol 45(1):69–75PubMedGoogle Scholar
  13. 13.
    Yin X, et al. (2012) Combined hepatocellular carcinoma and cholangiocarcinoma: clinical features, treatment modalities, and prognosis. Ann Surg Oncol 19(9):2869–2876CrossRefPubMedGoogle Scholar
  14. 14.
    Panjala C, et al. (2010) The diagnostic conundrum and liver transplantation outcome for combined hepatocellular-cholangiocarcinoma. Am J Transplant 10(5):1263–1267CrossRefPubMedGoogle Scholar
  15. 15.
    Liu CL, et al. (2003) Hepatic resection for combined hepatocellular and cholangiocarcinoma. Arch Surg 138(1):86–90CrossRefPubMedGoogle Scholar
  16. 16.
    Wang J, Wang F, Kessinger A (2010) Outcome of combined hepatocellular and cholangiocarcinoma of the liver. J Oncol 2010:7Google Scholar
  17. 17.
    Chi M, et al. (2012) Management of combined hepatocellular-cholangiocarcinoma: a case report and literature review. Gastrointest Cancer Res 5(6):199–202PubMedPubMedCentralGoogle Scholar
  18. 18.
    Sapisochin G, et al. (2011) Mixed hepatocellular cholangiocarcinoma and intrahepatic cholangiocarcinoma in patients undergoing transplantation for hepatocellular carcinoma. Liver Transpl 17(8):934–942CrossRefPubMedGoogle Scholar
  19. 19.
    Theise N, et al. (2010) Combined hepatocellular-cholangiocarcinoma. In: Bosman FT, Carneiro F, Hruban RH, Theise ND (eds) Who classification of tumours of the digestive system. Lyon: International Agency for Research on Cancer, pp 225–227Google Scholar
  20. 20.
    Purysko AS, et al. (2012) LI-RADS: a case-based review of the new categorization of liver findings in patients with end-stage liver disease. Radiographics 32(7):1977–1995CrossRefPubMedGoogle Scholar
  21. 21.
    Goodman ZD (2007) Neoplasms of the liver. Mod Pathol 20:S49–S60CrossRefPubMedGoogle Scholar
  22. 22.
    Nakanuma Y, et al. (2010) Pathological classification of intrahepatic cholangiocarcinoma based on a new concept. World J Hepatol 2(12):419–427CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Akiba J, et al. (2013) Clinicopathologic analysis of combined hepatocellular-cholangiocarcinoma according to the latest WHO classification. Am J Surg Pathol 37(4):496–505CrossRefPubMedGoogle Scholar
  24. 24.
    Kassahun WT, Hauss J (2008) Management of combined hepatocellular and cholangiocarcinoma. Int J Clin Pract 62(8):1271–1278CrossRefPubMedGoogle Scholar
  25. 25.
    Yang JD, et al. (2011) Factors that affect risk for hepatocellular carcinoma and effects of surveillance. Clin Gastroenterol Hepatol 9(7):617–623CrossRefPubMedGoogle Scholar
  26. 26.
    Sempoux C, et al. (2011) Intrahepatic cholangiocarcinoma: new insights in pathology. Semin Liver Dis 31(1):49–60CrossRefPubMedGoogle Scholar
  27. 27.
    de Groen PC, et al. (1999) Biliary tract cancers. N Engl J Med 341(18):1368–1378CrossRefPubMedGoogle Scholar
  28. 28.
    Xu J, et al. (2016) Combined hepatocellular-cholangiocarcinoma (cholangiolocellular type) with stem-cell features: a clinicopathologic analysis of 26 cases. Zhonghua Bing Li Xue Za Zhi 45(3):175–179PubMedGoogle Scholar
  29. 29.
    Zhang F, et al. (2008) Combined hepatocellular cholangiocarcinoma originating from hepatic progenitor cells: immunohistochemical and double-fluorescence immunostaining evidence. Histopathology 52(2):224–232CrossRefPubMedGoogle Scholar
  30. 30.
    Bellissimo F, et al. (2015) Diagnostic and therapeutic management of hepatocellular carcinoma. World J Gastroenterol 21(42):12003–12021CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Allaire GS, et al. (1988) Bile duct adenoma. a study of 152 cases. Am J Surg Pathol 12(9):708–715CrossRefPubMedGoogle Scholar
  32. 32.
    Maximin S, et al. (2014) Current update on combined hepatocellular-cholangiocarcinoma. Eur J Radiol Open 1:40–48CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Aoki K, et al. (1993) Combined hepatocellular carcinoma and cholangiocarcinoma: clinical features and computed tomographic findings. Hepatology 18(5):1090–1095CrossRefPubMedGoogle Scholar
  34. 34.
    Chen LD, et al. (2010) Intrahepatic cholangiocarcinoma and hepatocellular carcinoma: differential diagnosis with contrast-enhanced ultrasound. Eur Radiol 20(3):743–753CrossRefPubMedGoogle Scholar
  35. 35.
    Leoni S, et al. (2010) The impact of vascular and nonvascular findings on the noninvasive diagnosis of small hepatocellular carcinoma based on the EASL and AASLD criteria. Am J Gastroenterol 105(3):599–609CrossRefPubMedGoogle Scholar
  36. 36.
    Sherman M (2010) The radiological diagnosis of hepatocellular carcinoma. In: Am J Gastroenterol. United States. p 610–612.Google Scholar
  37. 37.
    Ros PR, et al. (1986) Mesenchymal hamartoma of the liver: radiologic-pathologic correlation. Radiology 158(3):619–624CrossRefPubMedGoogle Scholar
  38. 38.
    Kim KA, et al. (2006) Unusual mesenchymal liver tumors in adults: radiologic-pathologic correlation. AJR Am J Roentgenol 187(5):W481–W489CrossRefPubMedGoogle Scholar
  39. 39.
    Lai FM, et al. (1996) Hepatic mesenchymal hamartoma: a case report and radiological findings. Singap Med J 37(2):226–228Google Scholar
  40. 40.
    Horton KM, et al. (1999) CT and MR imaging of benign hepatic and biliary tumors. Radiographics. doi: 10.1148/radiographics.19.2.g99mr04431 Google Scholar
  41. 41.
    Ros PR, et al. (1986) Mesenchymal hamartoma of the liver: radiologic-pathologic correlation. Radiology. doi: 10.1148/radiology.158.3.3511498 Google Scholar
  42. 42.
    Kim SH, et al. (2007) Radiological spectrum of hepatic mesenchymal hamartoma in children. Korean J Radiol 8(6):498–505CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Cornette J, et al. (2009) Mesenchymal hamartoma of the liver: a benign tumor with deceptive prognosis in the perinatal period. Case report and review of the literature. Fetal Diagn Ther 25(2):196–202CrossRefPubMedGoogle Scholar
  44. 44.
    Anil G, Fortier M, Low Y (1001) Cystic hepatic mesenchymal hamartoma: the role of radiology in diagnosis and perioperative management. Br J Radiol 2011(84):e91–e94Google Scholar
  45. 45.
    Isaacs H Jr (2007) Fetal and neonatal hepatic tumors. J Pediatr Surg 42(11):1797–1803CrossRefPubMedGoogle Scholar
  46. 46.
    Lall C, et al. (2015) Renal collision and composite tumors: imaging and pathophysiology. Urology 86(6):1159–1164CrossRefPubMedGoogle Scholar
  47. 47.
    Lopez-Beltran A, et al. (2006) 2004 WHO classification of the renal tumors of the adults. Eur Urol 49(5):798–805CrossRefPubMedGoogle Scholar
  48. 48.
    Waldert M, et al. (2010) Hybrid renal cell carcinomas containing histopathologic features of chromophobe renal cell carcinomas and oncocytomas have excellent oncologic outcomes. Eur Urol 57(4):661–665CrossRefPubMedGoogle Scholar
  49. 49.
    Su D, Singer EA, Srinivasan R (2015) Molecular pathways in renal cell carcinoma: recent advances in genetics and molecular biology. Curr Opin Oncol 27(3):217–223CrossRefPubMedGoogle Scholar
  50. 50.
    Mucciardi G, et al. (2015) Transitional cell carcinoma of the renal pelvis with synchronous ipsilateral papillary renal cell carcinoma: case report and review. Urol Case Rep 3(4):93–95CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Upton MP, et al. (2005) Histologic predictors of renal cell carcinoma response to interleukin-2-based therapy. J Immunother 28(5):488–495CrossRefPubMedGoogle Scholar
  52. 52.
    Escudier B, et al. (2007) Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med 356(2):125–134CrossRefPubMedGoogle Scholar
  53. 53.
    Polascik TJ, Bostwick DG, Cairns P (2002) Molecular genetics and histopathologic features of adult distal nephron tumors. Urology 60(6):941–946CrossRefPubMedGoogle Scholar
  54. 54.
    Sukosd F, et al. (2003) Deletion of chromosome 3p14.2-p25 involving the VHL and FHIT genes in conventional renal cell carcinoma. Cancer Res 63(2):455–457PubMedGoogle Scholar
  55. 55.
    Gurel S, et al. (2013) Subtypes of renal cell carcinoma: MRI and pathological features. Diagn Interv Radiol 19(4):304–311PubMedGoogle Scholar
  56. 56.
    Sun MR, et al. (2009) Renal cell carcinoma: dynamic contrast-enhanced MR imaging for differentiation of tumor subtypes–correlation with pathologic findings. Radiology 250(3):793–802CrossRefPubMedGoogle Scholar
  57. 57.
    Vargas HA, et al. (2012) Renal cortical tumors: use of multiphasic contrast-enhanced MR imaging to differentiate benign and malignant histologic subtypes. Radiology 264(3):779–788CrossRefPubMedGoogle Scholar
  58. 58.
    Gordetsky J, Zarzour J (2016) Correlating preoperative imaging with histologic subtypes of renal cell carcinoma and common mimickers. Curr Urol Rep 17(7):52CrossRefPubMedGoogle Scholar
  59. 59.
    Campbell N, Rosenkrantz AB, Pedrosa I (2014) MRI phenotype in renal cancer: is it clinically relevant? Top Magn Reson Imaging 23(2):95–115CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Davidson AJ, et al. (1993) Renal oncocytoma and carcinoma: failure of differentiation with CT. Radiology 186(3):693–696CrossRefPubMedGoogle Scholar
  61. 61.
    Rosenkrantz AB, et al. (2010) MRI features of renal oncocytoma and chromophobe renal cell carcinoma. AJR Am J Roentgenol 195(6):W421–W427CrossRefPubMedGoogle Scholar
  62. 62.
    Perez-Ordonez B, et al. (1997) Renal oncocytoma: a clinicopathologic study of 70 cases. Am J Surg Pathol 21(8):871–883CrossRefPubMedGoogle Scholar
  63. 63.
    Harmon WJ, King BF, Lieber MM (1996) Renal oncocytoma: magnetic resonance imaging characteristics. J Urol 155(3):863–867CrossRefPubMedGoogle Scholar
  64. 64.
    Rosenkrantz AB, et al. (2010) Utility of the apparent diffusion coefficient for distinguishing clear cell renal cell carcinoma of low and high nuclear grade. AJR Am J Roentgenol 195(5):W344–W351CrossRefPubMedGoogle Scholar
  65. 65.
    Taouli B, et al. (2009) Renal lesions: characterization with diffusion-weighted imaging versus contrast-enhanced MR imaging. Radiology 251(2):398–407CrossRefPubMedGoogle Scholar
  66. 66.
    Mugiya S, et al. (2004) Ultrasonographic features of chromophobe cell renal carcinoma. Hinyokika Kiyo 50(12):865–868PubMedGoogle Scholar
  67. 67.
    Kondo T, et al. (2004) Spoke-wheel-like enhancement as an important imaging finding of chromophobe cell renal carcinoma: a retrospective analysis on computed tomography and magnetic resonance imaging studies. Int J Urol 11(10):817–824CrossRefPubMedGoogle Scholar
  68. 68.
    Shuch B, et al. (2012) Sarcomatoid renal cell carcinoma: a comprehensive review of the biology and current treatment strategies. Oncologist 17(1):46–54CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    de Peralta-Venturina M, et al. (2001) Sarcomatoid differentiation in renal cell carcinoma: a study of 101 cases. Am J Surg Pathol 25(3):275–284CrossRefPubMedGoogle Scholar
  70. 70.
    Cheville JC, et al. (2004) Sarcomatoid renal cell carcinoma: an examination of underlying histologic subtype and an analysis of associations with patient outcome. Am J Surg Pathol 28(4):435–441CrossRefPubMedGoogle Scholar
  71. 71.
    Shuch B, et al. (2009) Cytoreductive nephrectomy for kidney cancer with sarcomatoid histology–is up-front resection indicated and if not, is it avoidable? J Urol 182(5):2164–2171CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Schieda N, et al. (2015) Diagnosis of sarcomatoid renal cell carcinoma with CT: evaluation by qualitative imaging features and texture analysis. AJR Am J Roentgenol 204(5):1013–1023CrossRefPubMedGoogle Scholar
  73. 73.
    Sant GR, et al. (1984) Computed tomographic findings in renal angiomyolipoma: an histologic correlation. Urology 24(3):293–296CrossRefPubMedGoogle Scholar
  74. 74.
    Kloos RT, et al. (1995) Incidentally discovered adrenal masses. Endocr Rev 16(4):460–484PubMedGoogle Scholar
  75. 75.
    Katabathina VS, et al. (2013) Adrenal collision tumors and their mimics: multimodality imaging findings. Cancer Imaging 13(4):602–610CrossRefPubMedPubMedCentralGoogle Scholar
  76. 76.
    Ctvrtlik F, et al. (2009) Differential diagnosis of incidentally detected adrenal masses revealed on routine abdominal CT. Eur J Radiol 69(2):243–252CrossRefPubMedGoogle Scholar
  77. 77.
    Johnson PT, Horton KM, Fishman EK (2009) Adrenal mass imaging with multidetector CT: pathologic conditions, pearls, and pitfalls. Radiographics 29(5):1333–1351CrossRefPubMedGoogle Scholar
  78. 78.
    Otal P, et al. (1999) Imaging features of uncommon adrenal masses with histopathologic correlation. Radiographics 19(3):569–581CrossRefPubMedGoogle Scholar
  79. 79.
    Johnson PT, Horton KM, Fishman EK (2009) Adrenal imaging with multidetector CT: evidence-based protocol optimization and interpretative practice. Radiographics 29(5):1319–1331CrossRefPubMedGoogle Scholar
  80. 80.
    Piotrowski Z, et al. (2015) Renal cell carcinoma and an incidental adrenal lesion: adrenal collision tumors. Urology 85(3):e17–e18CrossRefPubMedGoogle Scholar
  81. 81.
    Reznek RH, Armstrong P (1994) The adrenal gland. Clin Endocrinol 40(5):561–576CrossRefGoogle Scholar
  82. 82.
    Szolar DH, Kammerhuber F (1997) Quantitative CT evaluation of adrenal gland masses: a step forward in the differentiation between adenomas and nonadenomas? Radiology 202(2):517–521CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Calvin T. Sung
    • 1
    • 2
  • Anup Shetty
    • 3
  • Christine O. Menias
    • 4
  • Roozbeh Houshyar
    • 1
  • Shreya Chatterjee
    • 1
  • Thomas K. Lee
    • 1
  • Paul Tung
    • 1
  • Mohammed Helmy
    • 1
  • Chandana Lall
    • 1
  1. 1.Department of Radiological Sciences, Irvine School of MedicineUniversity of CaliforniaOrangeUSA
  2. 2.School of MedicineUniversity of California RiversideRiversideUSA
  3. 3.Department of RadiologyWashington University School of Medicine in St. LouisSt. LouisUSA
  4. 4.Department of RadiologyMayo ClinicPhoenixUSA

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