Concurrent occurrence of terminal ileum carcinoid tumor and cecal adenocarcinoma: A collision tumor or composite tumor?

Byline: Meenal. Jain, K. Das

Sir,

We report a case of collision tumor. A 56-year-old male was admitted in the surgical ward with history of loss of appetite, weight loss, malaise, abdominal distention, melena and abdominal pain of 1-month duration. Endoscopy showed a growth at the terminal ileum and a constrictive lesion at proximal end of ascending colon. A hemicolectomy was done with removal of lymph nodes and a piece of omentum.

A right hemicolectomy specimen measuring 28 x 7cm along with piece of omentum was received. On cutting open, cut surface showed a polypoidal growth measuring 5 x 4cm occupying the terminal ileum and showing buckling of bowel wall. Cecum showed thickened wall which was grayish white in color and measured 6cm in length and was 1.5cms thick. Histological examination showed that the tumor was composed of two distinct neoplastic cell lines. One was a well differentiated adenocarcinoma, which infiltrated the muscle layer...