Medullary Carcinoma of the Colon: A Histopathologic Challenge

Medullary carcinoma of the colon is a rare histological variant characterized by a poorly differentiated morphology, an aberrant immunophenotype, and microsatellite instability. Despite the lack of glandular differentiation, medullary carcinoma is reported to have a good prognosis. It is typically located in the right colon and frequently affects older women. Due to its clinical, histological, biological, and genetic peculiarity, medullary carcinoma requires an accurate diagnosis and the awareness of this diagnostic possibility. We describe the morphological, immunohistochemical, and molecular findings of two interesting cases, the first one in the right colon of a patient and the second one in the terminal ileum of a patient with Crohn’s disease. Deeper knowledge of all the biological and clinical features will allow appropriate and specific treatment of this tumor in the future.

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S1752 Medullary Carcinoma of the Colon Presenting as Sepsis in a Patient With Ulcerative Colitis and Primary Sclerosing Cholangitis

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000780540.90398.f8 ◽

2021 ◽

Vol 116 (1) ◽

pp. S777-S777

Author(s):

Konstantinos Damiris ◽

Daniel Rim ◽

Qi Yu ◽

Sushil Ahlawat

Keyword(s):

Ulcerative Colitis ◽

Primary Sclerosing Cholangitis ◽

Sclerosing Cholangitis ◽

Medullary Carcinoma ◽

Carcinoma Of The Colon

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Microsatellite Instability in Medullary Carcinoma of the Colon

Rare Tumors ◽

10.4081/rt.2017.6541 ◽

2016 ◽

Vol 9 (1) ◽

pp. 23-25 ◽

Cited By ~ 1

Author(s):

Mario Martinotti ◽

Fernando Cirillo ◽

Marco Ungari ◽

Giulia Tanzi ◽

Giovanni Rolando ◽

...

Keyword(s):

Microsatellite Instability ◽

Medullary Carcinoma ◽

Good Health ◽

Caucasian Woman ◽

Poorly Differentiated Adenocarcinoma ◽

Carcinoma Of The Colon ◽

Stenotic Lesion ◽

Dna Mismatch ◽

Poorly Differentiated

Medullary carcinoma (MC) of the large intestine is a relatively new histological type of adenocarcinoma characterized by poor glandular differentiation and an intraepithelial lymphocytic infiltrate. MC can be associated to a defective mechanism for DNA mismatch repair, caused by the so-called microsatellite instability (MSI). We present the case of a 44 years old Caucasian woman, who referred to the Emergency Room with symptoms mimicking an acute appendicitis. Computed tomography and colonoscopy demonstrated an ulcerated and stenotic lesion of the caecum without signs of metastasis and peritoneal carcinosis. Patient underwent a laparoscopic right colectomy. The final pathologic findings provided the diagnosis of medullary carcinoma with MSI. Patient then underwent adjuvant chemotherapy according to the FOLFOX-4 protocol (association of 5-Fluorouracil, Leucovorin, and Oxaliplatin) for twelve cycles. At two-years follow-up, patient is disease free. MC in association with MSI is a non-frequent tumor of the colon characterized by a better prognosis compared to other types of poorly differentiated adenocarcinoma. In the observed case, 24 months after the surgical operation, the patient is in good health and there is no evidence of metastasis or relapse.

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