Work

Synchronous small bowel neuroendocrine tumour, colonic adenocarcinoma, and non-Hodgkin lymphoma: a rare triad of primary malignancies

Year: 2025

Type: article

Abstract: A man in his 70s presented to the Emergency Department with a history of progressive dyspnoea and was found to be anaemic. Endoscopic evaluation revealed a caecal lesion, confirmed histologically as a moderately differentiated adenocarcinoma. Staging computed-tomography imaging demonstrated widespread lymphadenopathy including pelvic, mediastinal and axillary regions, that appeared unlikely to be related to the colonic primary. Surgical resection of the right colon and a palpable axillary node was performed, during which a separate jejunal lesion was incidentally identified and resected. Histopathological analysis confirmed three distinct neoplasms: colonic adenocarcinoma, a small bowel neuroendocrine tumour, and non-Hodgkin lymphoma. Immunohistochemical and molecular profiling confirmed independent origins with no shared clonal relationship. The following case highlights the diagnostic and therapeutic challenges posed by synchronous multiple primary malignancies, particularly across divergent tissue lineages. Accurate histopathological distinction and multidisciplinary coordination are essential to guide management, prioritize treatment, and optimize patient outcomes in such exceptional presentations.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf970

Authors: Niamh Keating, Tim Harding, Leya Motala, Faraz Khan, Conor Shields

Institutions: Royal College of Surgeons in Ireland, Mater Misericordiae University Hospital

Language: English

Topic: Multiple and Secondary Primary Cancers

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000