Colon tumor
Carcinoma
Adenoma-like adenocarcinoma


Topic Completed: 1 July 2015

Revised: 10 June 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Villous adenocarcinoma [title] colon

Raul S. Gonzalez, M.D.
Page views in 2018: 665
Page views in 2019 to date: 517
Cite this page: Gonzalez R. Adenoma-like adenocarcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colontumorvillousadenocarcinoma.html. Accessed July 18th, 2019.
Definition / general
  • Well differentiated subtype of colorectal carcinoma with good prognosis that resembles villous adenoma on the surface (Anticancer Res 1998;18:2649)
  • Not formally recognized by the WHO
Terminology
Epidemiology
  • Approximately 3% - 5% of colorectal carcinomas have villous / adenoma-like features
Clinical features
  • Low rate of metastasis to lymph nodes and other organs
Diagnosis
  • 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 Gonzalez, M.D.

Villous adenocarcinoma of colon



Contributed by Semir Vranic, M.D.

10×


CK7

20×

CDX2

CK20



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)
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