Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma

T. Srikumar, M. Markow, B. Centeno, S. Hoffe, J. Tao, H. Fernandez, J. Strosberg, David Shibata

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Synchronous cancers of different primary origin are rare. Here, we describe the case of a patient with concomitant diagnoses of rectal adenocarcinoma and splenic marginal zone lymphoma (smzl). A 57-year-old woman initially presented with abdominal pain. Physical examination and computed tomography demonstrated massive splenomegaly, and a complete blood count revealed microcytic anemia and lymphopenia. During the subsequent evaluation, she presented with hematochezia, melena, and constipation, which prompted gastroenterology referral. Subsequent endoscopic rectal ultrasonography revealed a T3N1 moderately differentiated rectal adenocarcinoma, with computed tomography imaging of chest, abdomen, and pelvis confirming no metastasis. Thus, the cancer was classified as clinical stage T3N1M0, stage iii. Bone marrow biopsy confirmed co-existing marginal zone lymphoma, and with the clinical presentation of massive splenomegaly, a diagnosis of smzl was made. The patient’s management was individually tailored for simultaneous optimal treatment of both conditions. Concurrent treatment with neoadjuvant rituximab and 5-fluorouracil chemotherapy, with external-beam radiation therapy to the pelvis, was administered, followed by surgery consisting of en bloc splenectomy and distal pancreatectomy, and low anterior resection. The patient completed a standard course of adjuvant folfox (fluorouracil–leucovorin–oxaliplatin) chemotherapy and has remained disease-free for 7 years. To our knowledge, this report is the first to specifically describe simultaneous diagnoses of locally advanced rectal cancer and smzl. We also describe the successful combined neoadjuvant treatment combination of 5-fluorouracil, rituximab, and pelvic radiation.

Original languageEnglish (US)
Pages (from-to)e70-e74
JournalCurrent Oncology
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2016

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Lymphoma
Adenocarcinoma
Neoadjuvant Therapy
Splenomegaly
Pelvis
Fluorouracil
Tomography
Melena
Drug Therapy
Endosonography
Lymphopenia
Pancreatectomy
Gastrointestinal Hemorrhage
Blood Cell Count
Splenectomy
Gastroenterology
Constipation
Rectal Neoplasms
Abdomen
Abdominal Pain

All Science Journal Classification (ASJC) codes

  • Oncology

Cite this

Srikumar, T., Markow, M., Centeno, B., Hoffe, S., Tao, J., Fernandez, H., ... Shibata, D. (2016). Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma. Current Oncology, 23(1), e70-e74. https://doi.org/10.3747/co.23.2711

Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma. / Srikumar, T.; Markow, M.; Centeno, B.; Hoffe, S.; Tao, J.; Fernandez, H.; Strosberg, J.; Shibata, David.

In: Current Oncology, Vol. 23, No. 1, 01.01.2016, p. e70-e74.

Research output: Contribution to journalArticle

Srikumar, T, Markow, M, Centeno, B, Hoffe, S, Tao, J, Fernandez, H, Strosberg, J & Shibata, D 2016, 'Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma', Current Oncology, vol. 23, no. 1, pp. e70-e74. https://doi.org/10.3747/co.23.2711
Srikumar T, Markow M, Centeno B, Hoffe S, Tao J, Fernandez H et al. Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma. Current Oncology. 2016 Jan 1;23(1):e70-e74. https://doi.org/10.3747/co.23.2711
Srikumar, T. ; Markow, M. ; Centeno, B. ; Hoffe, S. ; Tao, J. ; Fernandez, H. ; Strosberg, J. ; Shibata, David. / Synchronous rectal adenocarcinoma and splenic marginal zone lymphoma. In: Current Oncology. 2016 ; Vol. 23, No. 1. pp. e70-e74.
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