Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2023; 11(24): 5772-5779
Published online Aug 26, 2023. doi: 10.12998/wjcc.v11.i24.5772
Synchronous rectal adenocarcinoma and intestinal mantle cell lymphoma: A case report
Kim-Van Vu, Nguyen-Van Trong, Nguyen-Thi Khuyen, Do Huyen Nga, Hoang Anh, Nguyen Tien Trung, Pham Trung Thong, Nguyen Minh Duc
Kim-Van Vu, Hoang Anh, Nguyen Tien Trung, Pham Trung Thong, Department of General Surgery, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
Kim-Van Vu, Hoang Anh, Department of Practical Surgery, Hanoi Medical University, Ha Noi 100000, Viet Nam
Nguyen-Van Trong, Department of Oncology, Hanoi Medical University, Ha Noi 100000, Viet Nam
Nguyen-Thi Khuyen, Pathology and Molecular Biology Center, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
Do Huyen Nga, Department of Hematologic Oncology, Vietnam National Cancer Hospital, Ha Noi 100000, Viet Nam
Nguyen Minh Duc, Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Viet Nam
Author contributions: Vu KV contributed to case file retrieval and case summary preparation; Khuyen NT and Trong NV contributed to preparation of manuscript and editing; All authors read and approved the final manuscript.
Informed consent statement: Our institution does not require ethical approval for reporting individual cases or case series. Written informed consent was obtained from the patient(s) for their anonymized information to be published in this article.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nguyen-Van Trong, MD, Department of Oncology, Hanoi Medical University, 1 Ton That Tung Trung Tu Ward Dong Da District Ha Noi City 100000, Vietnam. vantrong.hmu@gmail.com
Received: May 12, 2023
Peer-review started: May 12, 2023
First decision: May 31, 2023
Revised: June 18, 2023
Accepted: July 11, 2023
Article in press: July 11, 2023
Published online: August 26, 2023
Abstract
BACKGROUND

Mantle cell lymphoma (MCL) of the gastrointestinal tract is a rare malignancy, accounting for about 0.2% of malignant colorectal tumors. MCL synchronous with rectal adenocarcinoma is extremely rare. We know of only a few cases reported in the literature. We describe the case of a patient with synchronous rectal adenocarcinoma and intestinal MCL.

CASE SUMMARY

A 63-year-old man was admitted to our hospital due to abdominal pain and hematochezia over the past month. The patient was diagnosed with middle rectal cancer cT2N0M0 and underwent surgery. However, we found a large tumor in the small intestine during surgery. The patient underwent total mesorectal excision for rectal cancer and resectioning of the ileal segment containing the large mass. Pathology and immunohistochemistry revealed the presence of both rectal adenocarcinoma and pathognomonic MCL stage IIE presenting as multiple lymphomatous polyposis. The patient subsequently underwent RDHAP/RCHOP chemotherapy and was maintained with rituximab. A Positron Emission Tomography and Computed Tomography (PET/CT) scan showed that the disease responded well to treatment without tumor-increased metabolism in the gastrointestinal tract.

CONCLUSION

Synchronous rectal adenocarcinoma and intestinal MCL presenting as multiple lymphomatous polyposis are extremely rare. MCL is often discovered fortuitously when rectal cancer is diagnosed. The coexistence of these tumors poses treatment challenges.

Keywords: Mantle cell lymphoma, Multiple lymphomatous polyposis, Rectal adenocarcinoma, Synchronous, Gastrointestinal tract, Case report

Core Tip: Mantle cell lymphoma (MCL) of the gastrointestinal tract is an uncommon malignancy. Rectal adenocarcinoma is more common, but the coexistence of both is extremely rare. Their diagnosis should be based on histopathological and immunohistochemical features. MCL is a typically aggressive disease and has a poorer prognosis than adenocarcinoma. The treatment of two different simultaneously occurring cancers is a challenge, as it depends on the stage, prognosis, and response of each disease to treatment.