Techniques in Coloproctology

, Volume 14, Issue 2, pp 181–184 | Cite as

Synchronous collision malignant melanoma and adenocarcinoma of the rectum

  • A. R. Dias
  • R. A. Pinto
  • E. Mory
  • I. C. Silva
  • S. A. C. Siqueira
  • S. C. Nahas
  • I. Cecconello
  • S. D. Wexner
Case Report

Abstract

“Collision tumors” consist of two independent but coexisting tumors. This uncommon situation might be easily mistaken for a composite tumor where one histogenetic event originates from two apparently distinct neoplasms. Colorectal collisions are particularly unusual; here, we report the exceedingly rare case of a 61-year-old man with malignant melanoma and adenocarcinoma colliding in the rectum. Collision tumors have an idiopathic pathophysiology and in fact “accidental meeting” is accepted by many authors. This article discusses the concepts about cancer development, which are overlooked by this hypothesis, another theory to explain that this rare occurrence involves microenvironment changes.

Keywords

Collision tumor Melanoma Adenocarcinoma Physiopathology 

References

  1. 1.
    Pecorella I, Memeo L, Ciardi A, Rotterdam H (2007) An unusual case of colonic mixed adenoendocrine carcinoma: collision versus composite tumor. A case report and review of the literature. Ann Diagn Pathol 11:285–290CrossRefPubMedGoogle Scholar
  2. 2.
    Lewin K (1987) Carcinoid tumors and the mixed (composite) glandular-endocrine cell carcinomas. Am J Surg Pathol 11(Suppl 1):71–86PubMedGoogle Scholar
  3. 3.
    Fenoglio-Preiser CM (1999) Carcinomas and other epithelial and neuroendocrine tumors of the large intestine. In: Fenoglio-Preiser CM (ed) Gastrointestinal pathology. An atlas and text, 2nd edn. Lippincott-Raven, Philadelphia, pp 909–910Google Scholar
  4. 4.
    Grichnik JM, Burch JA, Schulteis RD et al (2006) Melanoma, a tumor based on a mutant stem cell? J Invest Dermatol 126:142–153CrossRefPubMedGoogle Scholar
  5. 5.
    Fang D, Nguyen TK, Leishear K et al (2005) A tumorigenic subpopulation with stem cell properties in melanomas. Cancer Res 65:9328–9337Google Scholar
  6. 6.
    Milne AN, Carvalho R, van Rees BP, van Lanschot JJ, Offerhaus GJ, Weterman MA (2004) Do collision tumors of the gastroesophageal junction exist? A molecular analysis. Am J Surg Pathol 28:1492–1498CrossRefPubMedGoogle Scholar
  7. 7.
    Padmore RF, Lara JF, Ackerman DJ et al (1996) Primary combined malignant melanoma and ductal carcinoma of the breast. A report of two cases. Cancer 78:2515–2525CrossRefPubMedGoogle Scholar
  8. 8.
    Wen YH, Giashuddin S, Shapiro RL, Velazquez E, Melamed J (2007) Unusual occurrence of a melanoma with intermixed epithelial component: a true melanocarcinoma?: case report and review of epithelial differentiation in melanoma by light microscopy and immunohistochemistry. Am J Dermatopathol 29:395–399CrossRefPubMedGoogle Scholar
  9. 9.
    Nobukawa B, Fujii H, Hirai S et al (1999) Breast carcinoma diverging to aberrant melanocytic differentiation: a case report with histopathologic and loss of heterozygosity analyses. Am J Surg Pathol 23:1280–1287CrossRefPubMedGoogle Scholar
  10. 10.
    Habr-Gama A, de Souza PM, Ribeiro U Jr (1998) Low rectal cancer: impact of radiation and chemotherapy on surgical treatment. Dis Colon Rectum 41:1087–1096CrossRefPubMedGoogle Scholar
  11. 11.
    Ulich TR, Kollin M, Lewin KJ (1988) Composite gastric carcinoma. Report of a tumor of the carcinomacarcinoid spectrum. Arch Pathol Lab Med 112:91–93PubMedGoogle Scholar
  12. 12.
    Newton MA, Clipson L, Thliveris AT, Halberg RB (2006) A statistical test of the hypothesis that polyclonal intestinal tumors arise by random collision of initiated clones. Biometrics 62:721–727CrossRefPubMedGoogle Scholar
  13. 13.
    Slaughter DP, Southwick HW, Smejkal W (1953) Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer 6:963–968CrossRefPubMedGoogle Scholar
  14. 14.
    Roh YH, Lee HW, Kim MC, Lee KW, Roh MS (2006) Collision tumor of the rectum: a case report of metastatic gastric adenocarcinoma plus primary rectal adenocarcinoma. World J Gastroenterol 12:5569–5572PubMedGoogle Scholar
  15. 15.
    Eguchi K, Yao T, Konomoto T, Hayashi K, Fujishima M, Tsuneyoshi M (2000) Discordance of p53 mutations of synchronous colorectal carcinomas. Mod Pathol 13:131–139CrossRefPubMedGoogle Scholar
  16. 16.
    Piérard GE, Fazaa B, Henry F, Kamoun MR, Piérard-Franchimont C (1997) Collision of primary malignant neoplasms on the skin: the connection between malignant melanoma and basal cell carcinoma. Dermatology 194:378–379CrossRefPubMedGoogle Scholar
  17. 17.
    Schwartz L, Balosso J, Baillet F, Brun B, Amman JP, Sasco AJ (2002) Cancer: the role of extracellular disease. Med Hypotheses 58:340–346CrossRefPubMedGoogle Scholar
  18. 18.
    Mueller MM, Fusenig NE (2004) Friends or foes–bipolar effects of the tumor stroma in cancer. Nat Rev Cancer 4:839–849CrossRefPubMedGoogle Scholar
  19. 19.
    Ishiguro K, Yoshida T, Yagishita H, Numata Y, Okayasu T (2006) Epithelial and stromal genetic instability contribuyes to genesis of colorectal adenomas. Gut 55:695–702CrossRefPubMedGoogle Scholar
  20. 20.
    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 26:637–641CrossRefPubMedGoogle Scholar
  21. 21.
    Bhowmick NA, Neilson EG, Moses HL (2004) Stromal fibroblasts in cancer initiation and progression. Nature 432:332–337CrossRefPubMedGoogle Scholar
  22. 22.
    Kalluri R, Zeisberg M (2006) Fibroblast in cancer. Nat Rev Cancer 6:392–401CrossRefPubMedGoogle Scholar
  23. 23.
    Orimo A, Grupta PB, Sgroi DC et al (2005) Stromal fibroblasts present in invasive human breast carcinomas promote tumor growth and angiogenesis through elevated SDF-1/CXCL12 secretion. Cell 121:335–348CrossRefPubMedGoogle Scholar
  24. 24.
    Schmidt-Hansen B, Klingelhofer J, Grum-Schwensen B et al (2004) Functional significance of metastasis inducing S100A4 (mts1) in tumor-stroma interplay. J Biol Chem 279:24498–24504CrossRefPubMedGoogle Scholar
  25. 25.
    Olumi AF, Grossfeld GD, Hayward SW, Carroll PR, Tisty TD, Cunha GR (1999) Carcinoma associated fibroblasts direct tumor progression of initiated human prostatic epithelium. Cancer Res 59:5002–5011PubMedGoogle Scholar
  26. 26.
    Parrott JA, Nilsson E, Mosher R et al (2001) Stromal-epithelial interactions in the progression of ovarian cancer: influence and source of tumor stromal cells. Mol Cell Endocrinol 175:29–39CrossRefPubMedGoogle Scholar
  27. 27.
    Nabili V, Natarajan S, Hirschovitz S, Bhuta S, Abemayor E (2007) Collision tumor of thyroid: metastatic lung adenocarcinoma plus papillary thyroid carcinoma. Am J Otolaryngol 28:218–220CrossRefPubMedGoogle Scholar
  28. 28.
    Di Marco A, Baccini P, Pastorino A, Nozza P (1998) Case report of a double ano-rectal neoplasia (adenocarcinoma and melanoma). Pathologica 90:36–41PubMedGoogle Scholar
  29. 29.
    Delikaris P, Koutmeridis D, Tsonis G, Asimaki A, Mouratidou D (1997) Synchronous anorectal malignant melanoma and rectal adenocarcinoma: report of a case. Dis Colon Rectum 40:105–108CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • A. R. Dias
    • 1
  • R. A. Pinto
    • 1
    • 3
  • E. Mory
    • 1
  • I. C. Silva
    • 2
  • S. A. C. Siqueira
    • 2
  • S. C. Nahas
    • 1
  • I. Cecconello
    • 1
  • S. D. Wexner
    • 3
  1. 1.Department of Gastroenterology, Division of Colorectal Surgery, Hospital das ClinicasUniversity of Sao Paulo, School of MedicineSao PauloBrazil
  2. 2.Department of Pathology, Hospital das ClinicasUniversity of Sao Paulo, School of MedicineSao PauloBrazil
  3. 3.Department of Colorectal SurgeryCleveland Clinic FloridaWestonUSA

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