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  • Synchronous colonic B cell lymphoma and adenocarcinoma in an elderly patient treated with R-mini-CHOP followed by resection

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Case Reports: Unusual presentation of more common disease/injury
Synchronous colonic B cell lymphoma and adenocarcinoma in an elderly patient treated with R-mini-CHOP followed by resection
  1. Daniel Schep1,
  2. Julie Ann Van Koughnett2,3,
  3. Vikram Velker2,4 and
  4. Rohann Jonathan Mark Correa2,4
  1. 1Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
  2. 2London Health Sciences Centre, London, Ontario, Canada
  3. 3Divisions of General Surgery and Surgical Oncology, Western University, London, Ontario, Canada
  4. 4Division of Radiation Oncology, Western University, London, Ontario, Canada
  1. Correspondence to Dr Julie Ann Van Koughnett; JulieAnn.VanKoughnett{at}lhsc.on.ca

Abstract

The simultaneous diagnosis of colonic lymphoma and adenocarcinoma in the same location is rare and presents challenges in its treatment considerations, especially in elderly patients. While previous cases have been described, there is little consistency in treatment regimens, and outcomes are generally poor. We describe the case of a man in his late 80s who presented with primary cecal and colonic B cell lymphoma, treated with R-mini-CHOP chemotherapy, but was found to have a residual adenocarcinoma in the cecum after treatment that was then successfully resected. The patient remains alive and well 3 years postoperation. This case highlights the need to consider lymphoma as a possible diagnosis for any colonic mass, and the need to consider rebiopsy of residual abnormal-appearing tissue postchemotherapy to confirm the diagnosis. Moreover, our report affirms that aggressive, curative-intent treatment with age-adjusted chemotherapy, and subsequent surgical resection is feasible for certain elderly patients with dual malignant diagnoses.

  • Oncology
  • Chemotherapy
  • Colon cancer
  • Malignant and Benign haematology

https://doi.org/10.1136/bcr-2020-236989

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    Footnotes

    • Contributors DS and RJMC were involved in the conception and design, acquisition of data, drafting and revising the article. VV and JAVK were involved in revising the article. All authors were involved in the final approval of the version submitted.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.