Colon

Carcinoma

Mucinous adenocarcinoma


Editorial Board Member: Catherine E. Hagen, M.D.
Editor-in-Chief: Debra L. Zynger, M.D.
Raul S. Gonzalez, M.D.

Topic Completed: 12 April 2021

Minor changes: 12 April 2021

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PubMed Search: Mucinous carcinoma [title] colon

Raul S. Gonzalez, M.D.
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Cite this page: Gonzalez RS. Mucinous adenocarcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colontumorcolloid.html. Accessed October 24th, 2021.
Definition / general
  • WHO recognized subtype of colorectal carcinoma with mucin lakes comprising at least 50% of tumor mass, though utility of 50% cutoff is unclear (Histopathology 2019;74:406)
Essential features
  • Most common subtype of colorectal carcinoma
  • Mucin production easily observed on histology
  • Some cases are microsatellite instability (MSI) high
  • Unclear whether worse prognosis than conventional colorectal carcinoma
Terminology
  • Variably called colloid carcinoma
Epidemiology
Sites
Pathophysiology
Clinical features
Prognostic factors
Case reports
Gross description
  • Exophytic, gelatinous mass
Gross images

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Causing intussusception

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Cecal tumor

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Arising in villous adenoma

Microscopic (histologic) description
  • Adenocarcinoma with strips of tumor cells floating in large extracellular mucin lakes comprising at least half of tumor mass
  • Signet ring cells (with intracellular mucin) may also be present but should comprise less than half of tumor
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D.

Abundant extracellular mucin

Epithelial cells within mucin

Positive stains
Molecular / cytogenetics description
Sample pathology report
  • Ascending colon, resection:
    • Mucinous adenocarcinoma, well differentiated (see synoptic report)
Differential diagnosis
Board review style question #1

Which of the following is true about mucinous adenocarcinoma of the colorectum?

  1. It is the most common subtype of colorectal carcinoma
  2. It unequivocally has a better prognosis than standard colorectal carcinoma
  3. It usually affects pediatric patients
  4. Signet ring cells are always at least a minor component
Board review style answer #1
A. It is the most common subtype of colorectal carcinoma

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Reference: Mucinous adenocarcinoma
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