Topic Completed: 1 July 2015

Minor changes: 1 October 2020

Copyright: 2002-2020,, Inc.

PubMed Search: Villous adenocarcinoma [title] colon

Raul S. Gonzalez, M.D.
Page views in 2019: 1,090
Page views in 2020 to date: 1,275
Cite this page: Gonzalez R. Adenoma-like. website. Accessed November 23rd, 2020.
Definition / general
  • Well differentiated subtype of colorectal carcinoma with good prognosis that resembles villous adenoma on the surface (Anticancer Res 1998;18:2649)
  • Formally recognized by the WHO
  • Approximately 3% - 5% of colorectal carcinomas have villous / adenoma-like features
Clinical features
  • Low rate of metastasis to lymph nodes and other organs
  • Biopsy may resemble villous adenoma, so clinical / endoscopic correlation is essential
Gross images

Images hosted on other servers:

Villous tumor with central ulceration

Microscopic (histologic) description
  • Invasive carcinoma with architectural and cytologic features resembling villous adenoma
  • May have traditional invasive component or invade by pushing
  • Mucinous features often present
  • Epithelial islands in desmoplastic stroma is a helpful finding (Am J Surg Pathol 2004;28:1460)
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D.

Villous adenocarcinoma of colon

Contributed by Semir Vranic, M.D., Ph.D.






Images hosted on other servers:

Abrupt transition from benign to malignant mucosa

Molecular / cytogenetics description
  • 24% of cases have microsatellite instability
Differential diagnosis
  • Villous adenoma: can be hard to distinguish on biopsy (subtle clues include gland distortion and desmoplasia)
Back to top
Image 01 Image 02