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Updated: May 24, 2026
Deficient Pms2, ERCC1, Ku86, CcOI in Field Defects During Progression to Colon Cancer
Published on: July 28, 2010
Colonic micropapillary carcinoma, a recently recognized subtype associated with histological adverse factors:
L S Lino-Silva1, R A Salcedo-Hernández, C H Caro-Sánchez
1Department of Gastrointestinal Pathology, Instituto Nacional de Cancerología, México City, México. saul.lino.sil@gmail.com
Aim:
Micropapillary carcinoma (MPC) is regarded as an aggressive variant of adenocarcinoma in any location. The reported proportion of a micropapillary carcinoma component in an entire tumour ranges from 5 to 95% and only one case of pure MPC has been reported. To date, approximately 130 cases of MPC in the colorectum have been reported, but it is likely that this small number is to some extent due to under-reporting because this pattern is not well recognized by the general pathologist. All previous studies have combined colonic and rectal primary tumours and most have only analysed patients with clinical Stages I or II.
Method:
We analysed 15 cases of MPC of the colon alone, diagnosed in our institution, and compared them with 105 conventional carcinomas of the colon.
Results:
An MPC component was present in 10% of all colonic carcinomas. These tumours presented at a median age of 56 years, and all were of American Joint Committee on Cancer Stages III and IV. Subserosal tissue invasion was present in every case, 60% had more than four positive lymph nodes, 60% were accompanied by poorly differentiated conventional carcinoma, 40% had had an incomplete resection and a third demonstrated lymphovascular invasion. Despite these adverse prognostic factors, tumours containing MPC showed the same survival, stage by stage, as conventional adenocarcinoma in multivariate analysis, although 3-year survival (81.7%vs 87.3%, P=0.035) was worse on univariate analysis.
Conclusion:
The histopathologist should be aware of the possibility of MPC. Three-year survival is worse than in patients with conventional colonic carcinomas in Stage III.
Insights
Micropapillary carcinoma (MPC) in the colon is an aggressive cancer variant. While often presenting with advanced features, MPC tumors show similar survival to conventional adenocarcinoma in multivariate analysis, though univariate analysis indicates worse 3-year survival.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Micropapillary carcinoma (MPC) is an aggressive variant of adenocarcinoma.
- MPC is under-recognized, leading to potential under-reporting in colorectal cancer.
- Previous studies often combined colonic and rectal tumors and focused on early stages.
Purpose of the Study:
- To analyze the clinicopathological features and outcomes of colonic micropapillary carcinoma (MPC).
- To compare colonic MPC with conventional colonic adenocarcinoma.
- To highlight the importance of recognizing MPC by histopathologists.
Main Methods:
- Analysis of 15 cases of colonic MPC diagnosed at the institution.
- Comparison with 105 cases of conventional colonic carcinoma.
- Evaluation of clinicopathological variables and survival data.
Main Results:
- MPC component found in 10% of colonic carcinomas, predominantly in Stages III and IV.
- Common adverse features included subserosal invasion, positive lymph nodes, poorly differentiated components, incomplete resection, and lymphovascular invasion.
- Multivariate analysis showed similar survival for MPC versus conventional adenocarcinoma, but univariate analysis revealed worse 3-year survival for MPC (81.7% vs. 87.3%).
Conclusions:
- Histopathologists must be aware of the potential for MPC in colorectal cancer.
- Colonic MPC, particularly in Stage III, is associated with worse 3-year survival compared to conventional adenocarcinoma.
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