Difference between revisions of "Medullary colorectal carcinoma"

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*Typically has [[MSI|Microsatellite instability]].<ref name=pmid24815832 >{{cite journal |vauthors=Cunningham J, Kantekure K, Saif MW |title=Medullary carcinoma of the colon: a case series and review of the literature |journal=In Vivo |volume=28 |issue=3 |pages=311–4 |date=2014 |pmid=24815832 |doi= |url=}}</ref>
*Typically has [[MSI|Microsatellite instability]].<ref name=pmid24815832 >{{cite journal |vauthors=Cunningham J, Kantekure K, Saif MW |title=Medullary carcinoma of the colon: a case series and review of the literature |journal=In Vivo |volume=28 |issue=3 |pages=311–4 |date=2014 |pmid=24815832 |doi= |url=}}</ref>
*Prognostic significance dependent on study.
*Prognostic significance dependent on study.
**Prognosis of medullary carcinoma with MSI is worse that conventional colorectal carcinoma without MSI.<ref>{{cite journal |vauthors=Gómez-Álvarez MA, Lino-Silva LS, Salcedo-Hernández RA, Padilla-Rosciano A, Ruiz-García EB, López-Basave HN, Calderillo-Ruiz G, Aguilar-Romero JM, Domínguez-Rodríguez JA, Herrera-Gómez Á, Meneses-García A |title=Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability |journal=Prz Gastroenterol |volume=12 |issue=3 |pages=208–214 |date=2017 |pmid=29123583 |pmc=5672702 |doi=10.5114/pg.2016.64740 |url=}}</ref>
**A small series suggests the prognosis of medullary carcinoma with MSI is worse that conventional colorectal carcinoma without MSI.<ref>{{cite journal |vauthors=Gómez-Álvarez MA, Lino-Silva LS, Salcedo-Hernández RA, Padilla-Rosciano A, Ruiz-García EB, López-Basave HN, Calderillo-Ruiz G, Aguilar-Romero JM, Domínguez-Rodríguez JA, Herrera-Gómez Á, Meneses-García A |title=Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability |journal=Prz Gastroenterol |volume=12 |issue=3 |pages=208–214 |date=2017 |pmid=29123583 |pmc=5672702 |doi=10.5114/pg.2016.64740 |url=}}</ref>
**A series with 102 cases suggests a better prognosis when compared on the basis of other pathological characteristics.<ref name=pmid25572685>{{cite journal |vauthors=Knox RD, Luey N, Sioson L, Kedziora A, Clarkson A, Watson N, Toon CW, Cussigh C, Pincott S, Pillinger S, Salama Y, Evans J, Percy J, Schnitzler M, Engel A, Gill AJ |title=Medullary colorectal carcinoma revisited: a clinical and pathological study of 102 cases |journal=Ann. Surg. Oncol. |volume=22 |issue=9 |pages=2988–96 |date=September 2015 |pmid=25572685 |doi=10.1245/s10434-014-4355-5 |url=}}</ref>
**A series with 102 cases suggests a better prognosis when compared on the basis of other pathological characteristics.<ref name=pmid25572685>{{cite journal |vauthors=Knox RD, Luey N, Sioson L, Kedziora A, Clarkson A, Watson N, Toon CW, Cussigh C, Pincott S, Pillinger S, Salama Y, Evans J, Percy J, Schnitzler M, Engel A, Gill AJ |title=Medullary colorectal carcinoma revisited: a clinical and pathological study of 102 cases |journal=Ann. Surg. Oncol. |volume=22 |issue=9 |pages=2988–96 |date=September 2015 |pmid=25572685 |doi=10.1245/s10434-014-4355-5 |url=}}</ref>



Revision as of 16:52, 31 December 2019

Medullary colorectal carcinoma is a rare type of colorectal carcinoma.

General

  • Rare subtype of colorectal carcinoma.
  • Typically has Microsatellite instability.[1]
  • Prognostic significance dependent on study.
    • A small series suggests the prognosis of medullary carcinoma with MSI is worse that conventional colorectal carcinoma without MSI.[2]
    • A series with 102 cases suggests a better prognosis when compared on the basis of other pathological characteristics.[3]

Gross

  • Well-circumscribed.

Microscopic

Features:

  • Poorly differentiated carcinoma:
    • Noninfiltrative border.
    • Solid pattern/nests.
    • No gland formation.
    • Lymphocytic infiltrate.

DDx:

IHC

Features:[1]

  • CDX2 +ve.
  • Beta-catenin +ve.
  • MLH1 loss of staining.

Note:

  • CDX2, beta-catenin, MLH1 useful for differentiating from poorly differentiated colorectal carcinoma.

See also

References

  1. 1.0 1.1 "Medullary carcinoma of the colon: a case series and review of the literature". In Vivo 28 (3): 311–4. 2014. PMID 24815832.
  2. "Medullary colonic carcinoma with microsatellite instability has lower survival compared with conventional colonic adenocarcinoma with microsatellite instability". Prz Gastroenterol 12 (3): 208–214. 2017. doi:10.5114/pg.2016.64740. PMC 5672702. PMID 29123583. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5672702/.
  3. "Medullary colorectal carcinoma revisited: a clinical and pathological study of 102 cases". Ann. Surg. Oncol. 22 (9): 2988–96. September 2015. doi:10.1245/s10434-014-4355-5. PMID 25572685.