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Surgical Pathology Criteria
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Adenosquamous Carcinoma of the Colon and Rectum

Definition

  • Carcinoma with malignant components exhibiting both glandular and squamous differentiation, arising in the colon and rectum

Covered separately

Diagnostic Criteria

  • Must have a component of usual gland forming colorectal adenocarcinoma
  • Must have a component of squamous carcinoma
    • Must be more than occasional small foci
  • Mixture may be intermingled or discrete foci
  • Must not involve anal squamous mucosa
    • Some require location >5-7 cm above dentate line
    • Anal squamous carcinomas frequently extend into the rectum
  • May be associated with inflammatory intestinal disorders

    • Robert V Rouse MD
    Department of Pathology
    Stanford University School of Medicine
    Stanford CA 94305-5342

    Original posting : 1/31/10, 11/12/11

Differential Diagnosis

  Colorectal Squamous Carcinoma Colorectal Adenosquamous Carcinoma Colorectal Adenocarcinoma with Squamous Metaplasia
Squamous component Malignant Malignant Benign
Glandular component Absent Malignant Malignant
Both components must be more than focal

Clinical

  • Frequently presents at high stage
  • Historically poor prognosis with surgical treatment
    • Especially for cases presenting at high stage

Grading / Staging

Bibliography

  • Bosman FT, Carneiro F, Hruban RH, Thiese ND (Eds). WHO Classifiication of Tumors of the Digestive System, IARC, Lyon 2010
  • Frizelle FA, Hobday KS, Batts KP, Nelson H. Adenosquamous and squamous carcinoma of the colon and upper rectum: a clinical and histopathologic study. Dis Colon Rectum. 2001 Mar;44(3):341-6.
  • Yokoi K, Tanaka N, Furukawa K, Seya T, Ohaki Y, Tajiri T. Case of adenosquamous carcinoma of the ascending colon. J Nippon Med Sch. 2008 Aug;75(4):242-6.
  • Petrelli NJ, Valle AA, Weber TK, Rodriguez-Bigas M. Adenosquamous carcinoma of the colon and rectum. Dis Colon Rectum. 1996 Nov;39(11):1265-8.
  • Cagir B, Nagy MW, Topham A, Rakinic J, Fry RD. Adenosquamous carcinoma of the colon, rectum, and anus: epidemiology, distribution, and survival characteristics. Dis Colon Rectum. 1999 Feb;42(2):258-63.
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