Colon

Polyps

Adenoma with invasive carcinoma



Topic Completed: 1 September 2010

Minor changes: 30 September 2020

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PubMed Search: Invasive carcinoma arising colonic adenoma

Shilpa Jain, M.D.
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Cite this page: Jain S. Adenoma with invasive carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colontumorcarcinomaarising.html. Accessed October 28th, 2021.
Definition / general
  • Invasive only if cancer has invaded beyond muscularis mucosa into submucosa
  • Can diagnose invasion without identification of submucosa if (a) marked desmoplasia, (b) infiltrative pattern, (c) ulceration or (d) clinical mass lesion
Terminology
  • Recommended to NOT use "carcinoma in situ" terminology in colorectum; use either high grade dysplasia or invasive carcinoma
Epidemiology
Prognostic factors
  • Recurrent disease, nodal metastases or residual local disease: 20% incidence if cancer is near margin, is poorly differentiated or if angiolymphatic invasion is present
Case reports
Treatment
Microscopic (histologic) description
  • How to Report:
    • Report type of carcinoma, grade, presence of angiolymphatic invasion (tumor emboli in true endothelial lined channels away from tumor, not retraction artifact), status of resection margins (close to margin is within one high power field or 1-2 mm from diathermy or at diathermy), presence of dysplasia
    • Sample report #1: poorly differentiated carcinoma arising within an adenoma, extending to resection margin, no angiolymphatic invasion
    • Sample report #2: moderately differentiated carcinoma arising with an adenoma; tumor 2.5 cm from resection margin, no angiolymphatic invasion
Microscopic (histologic) images

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Arising in villous adenoma

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