A CASE OF MALT LYMPHOMA OF THE RECTUM WITH SYNCHRONOUS RECTAL CANCER AND SYSTEMIC SPREAD OF RECURRENT BILATERAL BREAST CANCER

Abstract

We experienced a case of mucosa-associated lymphoid tissue (MALT) lymphoma of the rectum with synchronous rectal cancer and systemic spread of recurrent bilateral breast cancer. Three rectal lesions were detected by colonoscopy in a 64-year-old woman, who had previously undergone bilateral mastectomy. Chest radiography, an aspiration biopsy of pleural effusion, and bone scintigraphy indicated systemic spread of recurrent breast cancer. Barium enema and colonoscopy showed 3 rectal tumors (Rs=lesion 1, Rab=lesion 2, Rbp=lesion 3). Lesion 1 was diagnosed as a well-differentiated adenocarcinoma by biopsy. Reliable diagnoses could not be obtained from repeated biopsies of lesions 2 and 3. High anterior resection for lesion 1 (moderately differentiated adenocarcinoma, type I, ss, ly1, v1, n0, and stage II), and transanal incisional biopsy of lesion 3 were done. The resected specimen was histopathologically diagnosed as an extranodal marginal zone B-cell lymphoma MALT. Considering the advanced status of breast cancer and the patient's preference, no additional resection was done but radiotherapy (40 Gy) was conducted for the remaining MALT lymphoma. Oral tamoxifen was administered for recurrent breast cancer and the patient has since been carefully followed up.