Precision Pathology

Colo-Rectal Cancer Awareness in March!

Invasive Adenocarcinoma, Originating In A Colon Polyp

A middle-aged patient is presented with blood in their stool.

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Histology

This is an adenocarcimoma originating in a tubulovillous adenoma. The malignancy consists of acinar and cribriform arrangements. The malignant glands are lined by enlarged hyperchromatic nuclei with increased nuclear to cytoplasmic ratio. There are obvious nucleoli. Necrosis and numerous atypical mitotic figures are seen. The tumor invades into the submucosa; however, it does not invade the stock and was completely excised.

Summary

This is a malignant disease originating in a dysplastic polyp. However, the tumor did not involve the stock or the inked surgical margin. No further treatment was needed, since the polyp and the tumor within were completely excised.

Some Examples of Colon Cancer Symptoms

  • Unexplained weight loss, vomiting and feeling tired.
  • Blood in stool.
  • Changes in bowel movements, diarrhea and/or constipation.
  • Changes in the caliber of stool

Colo-Rectal Cancer Screening has multiple tools and is different from patient to patient, according to their risk factors and family history. Disscussing the case with the doctor is essential to discover what test would suit the patient best.

The screening test’s purpose is early discovery of polyps and signs of cancer. Polyps with dysplasia or malignancy discovered early, and completely excised, result in a better prognosis and do not need further treatment other than follow-up and screening. However, patients with risk factors, who are not properly screened, may develop more serious conditions. Delay in removal of a dysplastic polyp with malignancy may lead to extension of the tumor beyond the polyp into the colon, and may metastasize. Further surgery, as well as chemotherapy and radiation, may be required.

Preventive measures may help decrease the chances of colon cancer; however, no prevention is absolute. The best preventive measures are actually avoiding some of the risk factors.

So what are some of the risk factors controllable by a patient?

  • Smoking
  • Obesity
  • Excessive Consumption of Alcohol
  • Routine Consumption of Greasy Foods
  • Not enough Fibers and Vegetables
  • References to be added soon!

References to be added soon!

Hanan Ayoub