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Case Reports
. 2023 Nov 27;13(12):2263.
doi: 10.3390/life13122263.

Collision Tumors of the Colon and Peritoneum: Signet-Ring Cell Carcinoma and Granular Cell Tumor

Dorela-Codruta Lazureanu  1   2 , Denisa Anderco  2 , Sorin Dema  3   4 , Aura Jurescu  1 , Remus Cornea  1   2 , Octavia Vita  1 , Bogdan Tunescu  5 , Sorina Taban  1   2
Affiliations
Case Reports

Collision Tumors of the Colon and Peritoneum: Signet-Ring Cell Carcinoma and Granular Cell Tumor

Dorela-Codruta Lazureanu et al. Life (Basel). .

Abstract

Collision tumors, although rare, characterized by two distinctive (morphological, as well immunohistochemical) and spatially independent tumor components at the same location, are always puzzling for clinicians, pathologists, and patients because they do not fit into the usual approaches, being neither diagnostic nor therapeutic. Reviewing the specialized literature, to date, collision tumors have been reported in multiple locations such as the skin, esophagus, stomach, intestine, liver, kidney, bladder, adrenal gland, or thyroid. We report a case of coexistence at the same site of a malignant tumor of the ascending colon and a benign tumor emerging from the peritoneal lining, initially thought by the surgeon to be right-sided serosal carcinomatosis. But histopathological examination reveals that those multiple serosal nodules were benign granular cell tumors that have collided with highly aggressive transparietal signet-ring colon carcinoma. These results put the patient's prognosis and therapeutic strategy in a different light than the clinical and intraoperative evaluation.

Keywords: abdominal collision tumors; colon signet-ring carcinoma; peritoneal granular cell tumor.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Colon mucinous carcinoma signet-ring colon carcinoma invading submucosa, HE ×200.
Figure 2
Figure 2
Colon mucinous carcinoma, with presence of carcinomatous cells in the subserosa, tangentially to the black ink marking of the peritoneal lining, HE ×400.
Figure 3
Figure 3
Regional lymph node metastasis of the colon carcinoma, with adenocarcinoma pattern in the afferent lymphatics and subcapsular sinuses, HE ×200.
Figure 4
Figure 4
Peritoneal granular cell tumor nests and fascicles of large polygonal cells with abundant, eosinophilic, granular cytoplasm, HE ×100.
Figure 5
Figure 5
Regional lymph node metastasis of the colon carcinoma, with adenocarcinoma pattern, CK20 heterogeneous/patchy positive, DAB ×200.
Figure 6
Figure 6
Regional lymph node metastasis of the colon carcinoma, with adenocarcinoma pattern, CDX2 positive, DAB ×200.
Figure 7
Figure 7
Peritoneal granular cells tumor, with intense and diffuse positive reaction for S100 protein of the neoplastic cells, DAB ×200.
Figure 8
Figure 8
Peritoneal granular cell tumor, with faint and patchy positive reaction for CD68 of the neoplastic cells, DAB ×200.
See this image and copyright information in PMC

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