{"title":"Medullary Carcinoma of the Colon: Not as Favourable as Previously Thought?","authors":"Daniel Netto, Mugtaba Dafalla, Karim Muhammad, Haithum Tumeh, Chloe Sowerby, Konstantinos Kamposioras","doi":"10.1007/s12029-025-01304-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Medullary carcinoma of the colon (MCC) is a rare, evolving subtype of colorectal cancer that is histologically and clinically distinct from poorly differentiated and undifferentiated adenocarcinoma. Comprehensive meta-analyses show that MCCs predominantly have a mismatch repair-deficient (MMRd) phenotype, which typically predicts a more favourable prognosis.</p><p><strong>Case presentation: </strong>We present a unique case involving a male patient with an aggressive presentation of colon cancer. Histopathology supported a diagnosis of MCC, initially staged as T3N0M0. Shortly after resection, the patient presented with rapidly progressing metastatic disease involving brain and subcutaneous metastases and subsequent mortality.</p><p><strong>Conclusion: </strong>MCC is an understudied subpopulation of colon cancers. Historically, the presence of MMRd in early-stage colon cancer predicts a favourable prognosis and also a lack of benefit from adjuvant chemotherapy. Whether this also extrapolates to MCCs remains unclear, and as such, the case presented highlights the uncertainty in the current evidence base. Further research is warranted to help inform robust clinical management.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"185"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426073/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01304-x","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Medullary carcinoma of the colon (MCC) is a rare, evolving subtype of colorectal cancer that is histologically and clinically distinct from poorly differentiated and undifferentiated adenocarcinoma. Comprehensive meta-analyses show that MCCs predominantly have a mismatch repair-deficient (MMRd) phenotype, which typically predicts a more favourable prognosis.
Case presentation: We present a unique case involving a male patient with an aggressive presentation of colon cancer. Histopathology supported a diagnosis of MCC, initially staged as T3N0M0. Shortly after resection, the patient presented with rapidly progressing metastatic disease involving brain and subcutaneous metastases and subsequent mortality.
Conclusion: MCC is an understudied subpopulation of colon cancers. Historically, the presence of MMRd in early-stage colon cancer predicts a favourable prognosis and also a lack of benefit from adjuvant chemotherapy. Whether this also extrapolates to MCCs remains unclear, and as such, the case presented highlights the uncertainty in the current evidence base. Further research is warranted to help inform robust clinical management.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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