Netto Daniel, Dafalla Mugtaba, Muhammad Karim, Tumeh Haithum, Sowerby Chloe, Kamposioras Konstantinos
Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK.
Department of Pathology, Stockport NHS Foundation Trust, Stockport, UK.
J Gastrointest Cancer. 2025 Sep 11;56(1):185. doi: 10.1007/s12029-025-01304-x.
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.
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.
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.
结肠髓样癌（MCC）是一种罕见的、不断演变的结直肠癌亚型，在组织学和临床上与低分化和未分化腺癌不同。综合荟萃分析表明，MCC主要具有错配修复缺陷（MMRd）表型，这通常预示着更有利的预后。
我们报告了一例独特的病例，涉及一名表现为侵袭性结肠癌的男性患者。组织病理学支持MCC的诊断，最初分期为T3N0M0。切除术后不久，患者出现迅速进展的转移性疾病，累及脑和皮下转移灶，随后死亡。
MCC是一个研究不足的结肠癌亚群。从历史上看，早期结肠癌中MMRd的存在预示着良好的预后，也意味着辅助化疗无益处。这是否也适用于MCC尚不清楚，因此，本病例突出了当前证据基础中的不确定性。有必要进行进一步研究以指导合理的临床管理。
