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Primary adrenal gland carcinosarcoma associated with metastatic rectal cancer: a hitherto unreported collision tumor

Abstract

In this report we describe the case of a young woman with familial adenomatous polyposis who developed metastatic rectal cancer during pregnancy. At diagnosis, we decided to perform a transabdominal laparoscopic adrenalectomy, because of the high risk of bowel obstruction, and to define the origin of the adrenal gland lesion, suspected to be primary on the basis of imaging results. The histological specimen showed a collision tumor between an adrenal metastasis of a rectal tumor and a primary adrenal gland carcinosarcoma. The peculiarity of the case is due not only to its clinical presentation during pregnancy, but also to the presence of this uncommon adrenal collision tumor. A particular challenge for the clinician is to define the priority between these two tumors: the presence of two distinct and colliding aggressive neoplasms poses a problem in the choice of the best therapeutic approach, also given the impossibility to biopsy all metastatic sites. However, we decided to treat the patient as having a metastatic rectal cancer, because we had a solid histological confirmation of metastases.

Tumori 2011; 97(5): e27 - e30

Article Type: CASE REPORT

DOI:10.1700/989.10734

Authors

Federica Bertolini, Giulio Rossi, Federica Fiocchi, Marco Giacometti, Annalisa Fontana, Maria Chiara Gibertini, Luca Roncucci, Gabriele Luppi, Pietro Torricelli, Aldo Rossi, Pier Franco Conte

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Authors

  • Bertolini, Federica [PubMed] [Google Scholar]
    Department of Oncology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Rossi, Giulio [PubMed] [Google Scholar]
    Pathology Section, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Fiocchi, Federica [PubMed] [Google Scholar]
    Radiology Institute, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Giacometti, Marco [PubMed] [Google Scholar]
    Department of General Surgery, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Fontana, Annalisa [PubMed] [Google Scholar]
    Department of Oncology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Gibertini, Maria Chiara [PubMed] [Google Scholar]
    Radiology Institute, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Roncucci, Luca [PubMed] [Google Scholar]
    Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Luppi, Gabriele [PubMed] [Google Scholar]
    Department of Oncology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Torricelli, Pietro [PubMed] [Google Scholar]
    Radiology Institute, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Rossi, Aldo [PubMed] [Google Scholar]
    Department of General Surgery, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • Conte, Pier Franco [PubMed] [Google Scholar]
    Department of Oncology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy

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