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Intramucosal carcinoma on biopsy reliably predicts invasive colorectal cancer

MacDonald, Alastair W.; Tayyab, Muhammad; Arsalani-Zadeh, Reza; Hartley, John E.; Monson, J. R T


Alastair W. MacDonald

Muhammad Tayyab

Reza Arsalani-Zadeh

John E. Hartley

J. R T Monson


Background: The diagnosis of invasive malignancy on biopsies from colorectal neoplasms can be challenging. The concept of intramucosal carcinoma as an indicator of invasive malignancy is somewhat controversial within histopathology circles despite current World Health Organization (WHO) definitions. This study was designed to correlate the biopsy finding of intramucosal carcinoma with the pathology findings after formal surgical excision. Methodology: We evaluated 89 patients whose initial forceps biopsy contained only intramucosal carcinoma. All tumors were subsequently resected and subjected to formal pathology assessment. Results: Of 89 patients, 97% were shown to have frankly invasive adenocarcinoma by the current WHO definition. The positive predictive value of intramucosal carcinoma at biopsy for invasive cancer was 96.6% Conclusions: This study indicated that there should be a greater willingness among colorectal pathologists to accept the biopsy finding of intramucosal carcinoma as the earlier form of invasive malignancy. Clinicians should alter their treatment algorithms accordingly. © 2009 Society of Surgical Oncology.


MacDonald, A. W., Tayyab, M., Arsalani-Zadeh, R., Hartley, J. E., & Monson, J. R. T. (2009). Intramucosal carcinoma on biopsy reliably predicts invasive colorectal cancer. Annals of Surgical Oncology, 16(12), 3267-3270.

Journal Article Type Article
Acceptance Date Jun 14, 2009
Online Publication Date Oct 10, 2009
Publication Date Dec 1, 2009
Print ISSN 1068-9265
Electronic ISSN 1534-4681
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 16
Issue 12
Pages 3267-3270
Keywords Surgery; Oncology
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