The Aim: To present a clinical case of serrated colon adenocarcinoma. To demonstrate morphological and genetic features of these tumors and to determine their clinical management.
Key Points: Described case shows diagnostics of serrated colon adenocarcinoma. A 67-year-old woman presented for colonoscopy because of long constipation besides abdominal pain and distention have appeared recently. Colonoscopy was performed and she was found to have a 3.0 x 3.0-cm tumor next to hepatic flexure and pedunculated 1.2x0.7 cm polyp in sigmoid colon (type lp according to Paris classification). Endoscopic biopsies of these lesions were consistent with serrated adenocarcinoma and tubulovillous adenoma with foci of severe dysplasia. Additional diagnostic methods revealed no distant metastases. Patient was under went right hemicolectomy with D3 lymphodissection, lesion in sigmoid colon was removed using snare with electrocautery. Final pathology revealed no residual tissue in margins and no malignant cells in removed lymph nodes. Genetic diagnostics by PCR found high level of microsatellite instability and positive CpG island methylator phenotype (CIMP+) in tumor tissue.
Conclusions: According to WHO classification serrated lesion are considered to have malignant potential. They serve as the precursors for approximately 10% to 15% of sporadic colorectal cancer developed through the serrated pathway. These tumors were named serrated adenocarcinoma and had special morphological criteria that allow us to differentiate them with colorectal adenocarcinomas developed through the traditional pathway. Serrated adenocarcinoma has high level of microsatellite instability and positive CpG island methylator phenotype (CIMP+). Presence of microsatellite instability in tumor determines its more favorable prognosis because of tumor immunogenicity. Besides this type of cancer is more often responding to therapy with fluoropyrimidines.
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Pathol Oncol Res
January 2025
Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
Objective: Recently, several non-conventional variants of IBD-associated dysplasia have been described; however, their prevalence in Central-Eastern Europe is unknown. We aimed to perform a retrospective pilot study by re-evaluating several IBD-associated adenocarcinoma cases to survey the incidence of adjacent non-conventional dysplasia and validate that recent North American findings may apply to a European population.
Methods: Retrospectively, 28 randomly chosen cases of IBD-associated adenocarcinomas diagnosed between 2010 and 2022 were re-evaluated.
BMC Res Notes
December 2024
Department of Computer Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran.
This dataset contains demographic, morphological and pathological data, endoscopic images and videos of 191 patients with colorectal polyps. Morphological data is included based on the latest international gastroenterology classification references such as Paris, Pit and JNET classification. Pathological data includes the diagnosis of the polyps including Tubular, Villous, Tubulovillous, Hyperplastic, Serrated, Inflammatory and Adenocarcinoma with Dysplasia Grade & Differentiation.
View Article and Find Full Text PDFTurk J Gastroenterol
November 2024
Department of Gastroenterology, Endoscopy Center, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Background/aims: Growing recognition identifies sessile serrated lesions (SSL) as colorectal cancer (CRC) precursors. However, the SSL detection rate remains debatable and lacks a definitive consensus. Additionally, understanding the influencing factors in SSL development is limited.
View Article and Find Full Text PDFGastrointest Endosc
October 2024
Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan.
GE Port J Gastroenterol
October 2024
Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal.
Introduction: The serrated pathway contributes to interval colorectal cancers, highlighting the need for new biomarkers to assess lesion progression risk. The β1,6-GlcNAc branched -glycans expression in CRC cells was associated with an invasive phenotype and with immune evasion. Therefore, this study aims to identify potential risk factors for progression of serrated lesions (SLs) to malignancy, analyzing the -glycosylation profile of epithelial/infiltrating immune cells.
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