Synchronous collision malignant melanoma and adenocarcinoma of the rectum

Dias, André Roncon; Pinto, Rodrigo Ambar; Mory, Eduardo K.; Silva, I. C.; Siqueira, Sheila Aparecida Coelho; Nahas, Sérgio Carlos; Cecconello, Ivan; Wexner, Steven D.

doi:10.1007/s10151-010-0571-6

Cited by 7 publications

(11 citation statements)

References 26 publications

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Section: Discussionmentioning

confidence: 99%

“…2,3,7,9 Most synchronous cancers presented with similar symptoms of rectal bleeding and changes in bowel habits. 2,3,7 All synchronous colorectal cancers were located either in the rectum or the sigmoid. 2,3,7,9 This may be accounted for by the fact that most colorectal adenocarcinomas are found in the rectum or sigmoid.…”

Section: Discussionmentioning

confidence: 99%

“…Most patients, including the one reported here, presented relatively late with distant metastasis, perhaps because of the aggressive nature of anorectal melanoma compared with cutaneous melanoma. 2,7 All but one case was managed by APR. 7 There is no consensus at this moment regarding which surgical approach is preferred for the treatment of synchronous primary anorectal melanoma and colorectal adenocarcinoma, partly because of its rarity.…”

Section: Discussionmentioning

confidence: 99%

“…They come from 2 histogenetic events that occurred in proximity, and therefore these tumors have 2 different cell lineages that grow until these lesions get intimately juxtaposed. 7 As such, collision tumors were also included in the literature search because they were originally 2 separate primary tumors.…”

Section: Discussionmentioning

confidence: 99%

“…2,3,7 All synchronous colorectal cancers were located either in the rectum or the sigmoid. 2,3,7,9 This may be accounted for by the fact that most colorectal adenocarcinomas are found in the rectum or sigmoid. Most patients, including the one reported here, presented relatively late with distant metastasis, perhaps because of the aggressive nature of anorectal melanoma compared with cutaneous melanoma.…”

Section: Discussionmentioning

confidence: 99%

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Synchronous Primary Anorectal Melanoma and Sigmoid Adenocarcinoma: A Case Report

Lim

Foulger

Avramovic

et al. 2015

International Surgery

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Synchronous primary anorectal melanoma and colorectal adenocarcinoma is extremely rare, with only 5 cases reported in the literature. Here, a case is reported and the currently available literature is summarized. A 72-year-old white male presented with changes in his bowel habits and unintentional weight loss. Colonoscopy revealed a polypoid mass in the distal rectum extending to the anal verge anteriorly and a circumferential polypoid mass in the distal sigmoid colon. Biopsies were taken, which revealed poorly differentiated melanoma of the anorectal mass and moderately differentiated adenocarcinoma of the sigmoid mass with nodal involvement. Computed tomography of the abdomen showed liver metastasis. An extended abdominoperineal resection was undertaken for palliation, relief of symptoms, and definitive histology to guide further management. Consequently, a resection of the hepatic metastasis was attempted; however, macroscopic deposits were discovered on 7 of 8 liver segments perioperatively. He was subsequently referred to medical oncology for palliative chemotherapy. Synchronous primary anorectal melanoma and colorectal adenocarcinoma is rare, this being the sixth report found in the literature. In summary of the available cases, all synchronous cancers were located in the rectosigmoid and had very similar presentations. Most presented relatively late and were generally treated with abdominoperineal resection, which appears to be the best treatment option. Overall, prognosis appears to be dismal. General and colorectal surgeons should always be aware of the possibilities of simultaneous primary cancers because this can affect treatment modalities and prognosis for the patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Synchronous Primary Anorectal Melanoma and Sigmoid Adenocarcinoma: A Case Report

Lim

Foulger

Avramovic

et al. 2015

International Surgery

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Primary anorectal melanoma—a rare entity: case report

Kothonidis

Maassarani

Couvreur³

et al. 2017

Journal of Surgical Case Reports

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Anorectal melanoma is a rare disorder. There have only been a few cases reported and there is no consensus of treatment. We report a case of 50-year-old Caucasian man presenting intermittent prolapse of an anorectal mass during 6 months with occasional bleeding. Biopsies came up with the diagnosis of malignant melanoma. No distant metastases were found. He underwent an abdominoperineal resection due to internal sphincter invasion. A second tumour was diagnosed in final histologic examination: a dysplastic rectal polyp invaded by the melanoma (collision tumour). At 12 months of follow up he presented loco-regional recurrence (a single pelvic lymph node) and hepatic metastases. He was included in a study protocol comparing new medical treatments (nivolumab versus ipilimumab or both).

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Objective response to mTOR inhibition in a metastatic collision tumor of the liver composed of melanoma and adenocarcinoma with TSC1 loss: a case report

Bhangoo

Zhou

Ali³

et al. 2017

BMC Cancer

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BackgroundCollision tumors are uncommon but well described clinical entities composed of distinct tumor histologies occurring within the same anatomic site. Optimal management of patients with collision tumors remains highly variable and depends on clinical characteristics such as the involved tumor types, predominant histology, as well as the extent of disease. Comprehensive genomic profiling is a means of identifying genomic alterations to suggest benefit from targeted therapy.Case presentationA 78-year-old woman presented to medical oncology with liver metastases occurring within the background of a 1-year history of uveal melanoma. Biopsy of the liver metastases revealed presence of adenocarcinoma along with nests of malignant melanoma consistent with a collision tumor. The disease was refractory to several lines of conventional cytotoxic chemotherapy, and the patient later developed pulmonary metastases while on chemotherapy. The patient’s tumor tissue was assayed by comprehensive genomic profiling which revealed presence of a TSC1 partial loss. The patient was subsequently initiated on temsirolimus 15 mg intravenously weekly for 4 months. Restaging imaging demonstrated a partial response to therapy by RECIST 1.1 criteria and clinical benefit for 6 months until the patient passed away secondary to unrelated causes.ConclusionsWe report the first case of a collision tumor composed of adenocarcinoma and melanoma with a TSC1 mutation that objectively and durably responded to mTOR inhibition.

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Synchronous collision malignant melanoma and adenocarcinoma of the rectum

Cited by 7 publications

References 26 publications

Synchronous Primary Anorectal Melanoma and Sigmoid Adenocarcinoma: A Case Report

Synchronous Primary Anorectal Melanoma and Sigmoid Adenocarcinoma: A Case Report

Primary anorectal melanoma—a rare entity: case report

Objective response to mTOR inhibition in a metastatic collision tumor of the liver composed of melanoma and adenocarcinoma with TSC1 loss: a case report

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