Rare comorbidity of colon cancer, hepatic malignant mesothelioma, and abdominal Ewing's sarcoma: a case report

Our plain-English summary of Rare comorbidity of colon cancer, hepatic malignant mesothelioma, and abdominal Ewing's sarcoma: a case report, by Y. Li, L. Teng, S. Wang, et al (Frontiers in Oncology, 2025).

The study

• Authors: Y. Li, L. Teng, S. Wang, X. Wu, T. Huang
• Journal: Frontiers in Oncology
• Published: 2025;15:1558347
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

We present a rare case of a patient with a history of colon cancer who subsequently developed hepatic mesothelioma and extraosseous Ewing's sarcoma 10 years after surgery. The diagnosis of three completely different types of cancer in the same patient over a decade was confirmed through histopathological and immunohistochemical analysis. This case highlights the importance of clinicians maintaining a heightened awareness and clinical vigilance regarding multiple primary cancers, ensuring patients receive comprehensive diagnosis and treatment for improved prognosis and desired survival outcomes.

Copyright © 2025 Li, Teng, Wang, Wu and Huang.

In plain English

This was a case report from China about one patient who developed three different cancers. A 42-year-old man came to the First Affiliated Hospital of Henan University of Science and Technology in August 2024 with one week of intermittent pain in the right upper abdomen. Six years earlier he had surgery for sigmoid colon cancer followed by chemotherapy; the abstract instead gives this interval as 10 years. He had a 5-year smoking history and no history of asbestos exposure. Biopsies, examined under the microscope and with tissue staining, found that a pelvic mass was consistent with extraosseous Ewing's sarcoma and that a liver mass tended to originate from malignant mesothelioma. The authors judged that the tumors did not arise from the colon cancer. After 4 cycles of chemotherapy, the pelvic mass had shrunk, while the liver mesothelioma had not changed significantly. Treatment for the liver tumor was then changed, and follow-up was ongoing. Genetic testing found no mutated genes. The authors concluded that clinicians should stay alert to multiple primary cancers. They said the relationship between the possible causes in this case remains unclear.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 42-year-old man seen at the First Affiliated Hospital of Henan University of Science and Technology, China, on August 3, 2024, with a past history of sigmoid colon cancer and hepatitis B
• Exposure: No asbestos exposure was reported. The patient had a 5-year smoking history and had received prior chemotherapy (oxaliplatin and capecitabine) after colon cancer surgery.
• Main results:
  • Pathology of the pelvic mass (biopsy of the patient's tumor) was consistent with extraosseous Ewing's sarcoma.
  • Pathology of the liver mass reported that it tended to originate from malignant mesothelioma (positive for WT-1, CR and CK5/6; negative for D2-40).
  • After 4 cycles of chemotherapy, the patient's pelvic mass had decreased in size and the liver mesothelioma showed no significant change. Treatment for the liver mesothelioma was then adjusted.
  • The patient's cancer antigen 125 was 688 U/ml at admission and fell to between 2.5 and 4.5 U/mL at follow-up tests from September to December 2024.
  • Genetic testing in this patient found no mutated genes, and microsatellite status was stable.
  • The authors suggested that the patient's 5-year smoking history may be associated with his multiple primary cancers.
• The authors' conclusion: The authors concluded that raising clinicians' awareness of risk assessment for multiple primary cancers, and screening high-risk people, is key to early diagnosis and treatment.
• Limitations the authors state:
  • The authors stated that the relationship between the possible causative factors in this case remains unclear and needs further study.

Topics

Medical terms in this study, explained in our Lexicon: Colorectal Cancer, Mesothelioma, Sarcoma, Prognosis.

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• Benign cystic mesothelioma of the liver: A rare hepatic cyst — W. Wang, H.Y. Lai, et al. (2021)
• Hepatic Benign Cystic Mesothelioma in Adults: A Case Report of a Rare Hepatic Cyst — A. Mohamed, S. Elsherif, et al. (2024)
• Rare confounder: benign multicystic peritoneal mesothelioma in a patient with mucinous colon adenocarcinoma — K.K. Patel, G.P. Stinson, et al. (2024)
• Loss of BAP1 expression is very rare in peritoneal and gynecologic serous adenocarcinomas and can be useful in the differential diagnosis with abdominal mesothelioma — J. Andrici, J. Jung, et al. (2016)
• Benign Multicystic Peritoneal Mesothelioma (BMPM) as a rare cause of abdominal pain in a young male: case report and review of the literature — S. Gussago, P. Spina, et al. (2019)

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