One patient, two lymphomas, three primaries.

Concomitant adenocarcinoma and non-Hodgkin's lymphoma, both located in the intestinal tract, are unusual. Collision tumors of the colon on the other hand are extremely rare neoplasms. A case of true collision tumor of a marginal zone lymphoma and a moderately differentiated adenocarcinoma of the ascending colon (hepatic flexure) is reported. Simultaneously, a third primary is identified as follicular lymphoma involving the terminal ileum. Correlation with clinical history, radiology investigations, endoscopic findings and histological examination of the resected specimen as well as the use of ancillary techniques such as immunohistochemistry are the most useful in making the correct diagnosis of a synchronous three primaries involving the small bowel and colon. Therefore, we present these three primary synchronous neoplasms involving two different parts of the gastrointestinal tract, with two of these three primaries colliding at one organ.

Upper gastrointestinal tract bleeding caused by a gastrointestinal stromal tumor of the stomach: a case report.

We report a case of upper gastrointestinal bleeding caused by a gastrointestinal stromal tumor in a 50-year old man. The patient was having melena for two months, and on admission he was hemodynamically stable. Upper G.I endoscopy showed diffuse gastritis and an extrinsic compressing mass in the upper part of the stomach. CT scan of the abdomen showed exophytic mass in the fundus of the stomach, with central necrosis. The patient was submitted to operative management. There were no features of dissemination but there was invasion of the hilum of the spleen. Wide local resection and splenectomy performed. Post operative course was complicated by a bleeding from the anastomotic site that required re-exploration and suturing of the bleeding vessel. Histologic examination revealed that it was composed of spindle-shaped cells with elongated nuclei. Post operatively the patient received adjuvant treatment with Imatinib [Gleevec]. The patient has an uneventful follow-up period so far.

Abscess of the abdominal wall resulting from perforated ascending colon cancer.

We report an unusual case of abscess of the abdominal wall as the initial symptom of a perforated right-sided colon cancer in a 62-year old man. Clinical examination revealed a non-fluctuating, tender, firm mass approximately 7 x 5 cm in diameter with overlying cellulitis in the right loin. Abdominal examination showed a fixed mass on the right side of the abdomen. Computed tomography (CT scan) confirmed the presence of a mass arising from the right colon with infiltration of the subcutaneous tissue by this intra-abdominal mass. Right hemicolectomy with lymph node dissection and en-bloc partial resection of the adherent parietal wall was performed and the final pathology showed a moderately differentiated mucinous adenocarcinoma. We report a case of ascending colon cancer presenting by an abscess of the abdominal wall.

Primary lymphoma of the cecum: a case report.

We report here a case of primary colorectal T-cell lymphoma of the cecum in a 30-year-old man. Patient presented with a history of abdominal pain, fever, vomiting and hematochezia. Clinical examination was unremarkable and colonoscopy showed an ulcerating mass in the colon. A right hemicolectomy with dissection of the paracolic lymph nodes was performed. The final histopathological examination showed a primary T- cell lymphoma of the cecum. Staging didn't show any involvement in any other sites of the body. Primary colon lymphoma is a rare gastrointestinal tumor that represents less than 1% of the gastrointestinal lymphomas. Peripheral T-cell lymphoma represents a relatively small proportion of lymphomas and has a lower prevalence in Western countries. The risk factors, clinical presentation, staging, prognostic factors and treatment modalities of extra-nodal lymphoma are discussed.

A ruptured retroperitoneal germ cell tumor with invasion into the duodenum: a case report.

We report a rare case of a retroperitoneal germ cell tumor in a 31 years old male who presented with an acute abdomen. He gave a six-months history of back pain and significant weight loss. Clinical examination and ultrasound of the testes didn't show any primary focus. Intraoperative findings showed a retrolperitoneal midline mass that has ruptured into the peritoneal cavity and has invaded into the duodenum. The final pathology revealed a yolk sac tumor. We present this rare case of a primary para-aortic extragonadal yolk sac tumor and the differential diagnosis of a retroperitoneal mass.