We report here a case of primary colorectal T-cell lymphoma of the cecum in a 30-year-old man. Patient presented with a history of abdominal pain, fever, vomiting and hematochezia. Clinical examination was unremarkable and colonoscopy showed an ulcerating mass in the colon. A right hemicolectomy with dissection of the paracolic lymph nodes was performed. The final histopathological examination showed a primary T- cell lymphoma of the cecum. Staging didn't show any involvement in any other sites of the body. Primary colon lymphoma is a rare gastrointestinal tumor that represents less than 1% of the gastrointestinal lymphomas. Peripheral T-cell lymphoma represents a relatively small proportion of lymphomas and has a lower prevalence in Western countries. The risk factors, clinical presentation, staging, prognostic factors and treatment modalities of extra-nodal lymphoma are discussed.
Synchronous cancers are defined as malignant tumours that occur simultaneously, each of which must be distinct with no possibility of one being the metastasis of the other. A 65 year old gentleman presented to us with two month history of epigastric pain associated with anaemia, loss of appetite and weight. He has no history of malignancy in his family. Colonoscopy revealed tumours at transverse colon and caecum. Intra-operatively, tumours were sited at caecum, transverse colon and jejunum. Tumours were diagnosed as synchronous adenocarcinoma histopathologically with loss of expression of MLH1 and MSH2. From literature search, this is the first reported triple synchronous tumours of the caecum, transverse colon and jejunum. We believe that this gentleman developed triple synchronous tumour through the sporadic MSI pathway.