Medullary Adenocarcinoma of Colon: Distinct Entity with a Favorable Prognosis

Sharma, Amit; Sharma, Namita; Pantangi, Pramod; Sampath, Praveen

doi:10.14309/00000434-201210001-01409

Cited by 1 publication

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“…of cases Gender Age Presentation Location of the tumor Differentiation/stage Biomarker testing Immunohistochemical analysis Sharma et al . [ 11 ] 2012 1 Female 74 Abdominal pain (LLQ), fatigue, intermittent diarrhea, and weight loss (15 lbs in 2 months) Right-sided tumor; ascending colon Undifferentiated Microsatellite instability Negative CDX-2, CK20, CK7, TTF-1, S-100 protein, MART1, PAX-8, chromogranin, synaptophysin, estrogen receptors, and hepatocyte-specific antigen Jain et al . [ 12 ] 2014 1 Female 72 Bleeding per rectum Abdominal cramps and loose stool Left-sided tumor Poorly differentiated G3 T2N0M0 Microsatellite instability Positive staining for MSH2 and MSH6 Loss of MLH1 and PMS2 protein expression Cunningham et al .…”

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Colonic medullary carcinoma: an exceedingly rare type of colorectal malignancy: a case report and review of the literature

Al-Ishaq,

Al-Dhaheri,

Toffaha

et al. 2023

J Med Case Reports

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Background Medullary carcinoma of the colon is a rare subtype of colorectal cancer that has a unique, and sometimes varied, clinical and histologic profile. It usually presents in adult patients older than 50 years. Here, we report a unique case of young male patient who initially presented with abdominal pain followed by a large bowel obstruction. Case presentation A 40-year-old SriLankan male presented with right-sided abdominal pain and on examination, there was a palpable right iliac fossa mass. Colonoscopy and a computed tomography scan revealed cecal mass. Later, while waiting for elective resection, the patient developed symptoms and signs of a large bowel obstruction. He underwent a laparoscopic right hemicolectomy with an uneventful postoperative course. The histopathologic evaluation of the resected specimens showed invasive carcinoma with syncytial growth pattern, foci of lymphoid host response, and dirty necrosis, in keeping with a medullary carcinoma pT4a pN2b. Unlike most reported medullary carcinoma cases, this patient was young and caudal-related homeobox transcription factor 2 positive. Conclusion We have reported another case of medullary carcinoma of the colon in a young patient with unique histologic characteristics. Reporting such cases helps in refine understanding of the histologic and genetic, as well as clinical, phenotypes of medullary carcinoma of the colon.

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