Rare Case: Two Different Cancers Found Together in One Area

About this article: Doctors reported an 86-year-old man who had both a colon cancer and a rare appendix cancer at the same time. He came to the hospital with abdominal pain and diarrhea. Scans suggested colon cancer, so surgeons removed part of his colon and nearby lymph nodes.

After surgery, tests showed two separate cancers:

• a tubular adenocarcinoma (common type of colon cancer) in the cecum, and

• a goblet cell adenocarcinoma in the appendix, which is a rare tumor that behaves partly like a glandular cancer and partly like a neuroendocrine tumor.

Because the two cancers looked and acted differently under the microscope, doctors concluded they were two independent tumors, not one that had spread.

Treatment and Outcome

The man at first declined chemotherapy but started treatment later after a lung spot appeared, likely a metastasis. He was treated with chemotherapy drugs (capecitabine, bevacizumab, then raltitrexed + bevacizumab) and remained stable for at least eight months with no new cancer growth in the abdomen.

Why It Matters

Having two unrelated cancers in the same region is extremely rare and can be hard to detect before surgery. The authors stress the importance of detailed lab testing (including special staining techniques) to correctly identify such cases.

Treatment usually involves surgery, sometimes followed by chemotherapy similar to colon cancer regimens.

Goblet cell cancers of the appendix are uncommon but can be aggressive. Early, accurate diagnosis helps doctors choose the right treatment and improve survival chances.