Intramucosal carcinoma

Last author update: 1 June 2013
Last staff update: 14 June 2022

Copyright: 2003-2023,, Inc.

PubMed Search: Intramucosal carcinoma[TI] esophagus

See also: Adenocarcinoma, Arising in ectopic gastric mucosa, Gastroesophageal junction

Elliot Weisenberg, M.D.
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Cite this page: Weisenberg E. Intramucosal carcinoma. website. Accessed June 2nd, 2023.
Definition / general
  • Carcinoma that has penetrated through basement membrane of glands of lamina propria but not yet invaded through muscularis mucosae into submucosa; most biopsy specimens will not be deep enough to rule out submucosal invasion
  • Epidermiology, sites, pathophysiology similar to adenocarcinoma
  • In AJCC staging, invasion of lamina propria or muscularis mucosae without involvement of submucosa is a T1a primary tumor
Clinical features
  • True intramucosal carcinoma is asymptomatic although patients often have GERD symptoms
  • Endoscopic biopsy
Prognostic factors
  • Usually node negative (J Am Coll Surg 2006;203:152)
  • 10 year survival after esophagectomy for stage IA (T1aN0M0) is 75% worldwide, similar to stage 0 disease
  • Esophagectomy, mucosectomy, radiofrequency ablation
Microscopic (histologic) description
  • Odze requires one of these findings (J Clin Path 2006;59:1029)
    • Single cells or small clusters of tightly compact back to back glands in lamina propria
    • Complex gland in gland or "cribriforming" pattern, with expansion of lamina propria and distortion of surrounding crypts
    • Neoplastic cells or glands show back to back or highly irregular architectural glandular arrangement, which cannot be explained by the preexisting Barrett glands, as previously defined by Ormsby (Gut 2002;51:671)
Microscopic (histologic) images

AFIP images

High grade dysplasia, early intramucosal carcinoma

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Intramucosal carcinoma

Suggestive of intramucosal carcinoma

Differential diagnosis
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