Clear cell adenocarcinoma of the colon is a unique morphological variant of intestinal carcinoma: Case report with molecular analysis

Abstract

Here we report a new case of clear cell adenocarcinoma (CCA) of the colon in a 54-year-old Caucasian man. Despite of the previous reported cases, the lesion was located in the right colon and was not associated with the conventional adenoma. We performed immunohistochemical and molecular analyses in order to explore whether the CCA had the molecular features generally associated with conventional colorectal carcinoma. The immunohistochemical and molecular analyses showed that the different morphology of CCA does not reflect a distinct biological entity but only an unusual morphological variant of intestinal carcinoma.

Clear Cell Adenocarcinoma of the Colon in the Setting of Attenuated Familial Polyposis: A Rare Variant of Primary Colonic Adenocarcinoma

“…However, its occurrence in male patients declines this hypothesis. Other authors are proponents of a classic carcinogenesis pathway according to the linear sequence "adenomaadenocarcinoma", and suggest that tumor-cells cytoplasmic clarification is due to glycogen accumulation [6,7]. In our observation, association of clear cell adenocarcinoma with attenuated AFP supports strongly this hypothesis, however clarified cytoplasmic features weren't observed in concomitant six adenomas.…”

Clear cell change in colonic adenomas: case report and review of the literature

“…An up to date review of the English language literature identified 13 reported cases of clear cell change occurring in colonic adenoma and adenocarcinoma including the case reported here (see the table) [1][2][3][4][6][7][8][9][10][11] . Of those cases 9 of 13 (69.2%) occurred in male patients.…”

“…Five of 13 (38.5%) were diagnosed as invasive adenocarcinomas. Eight of 13 (61.5%) were treated endoscopically and the remainder were treated with surgical excision [1][2][3][4][6][7][8][9][10][11] . One retrospective study of 3486 colonic adenomas found changes in only 3 specimens (0.086%) [2] .…”

“…While its morphology is distinct, clear cell change in colonic adenocarcinomas probably arises from similar molecular mechanisms to conventional adenocarcinomas. In fact, in some studies the clear cell areas of these lesions showed positive reactivity to immunohistochemical stains for p53 and nuclear β-catenin [1,2,4,[6][7][8]12] . Our case showed focal positive staining for p53 and diffuse nuclear positivity for β-catenin.…”

“…These changes are typically seen in elderly male patients, with a predominance in the left colon [2,3] . Though these findings are rare, some small studies suggest that while clear cell changes are an unusual morphologic variant, they are associated with similar molecular and immunohistochemical findings to conventional colonic tumors, suggesting a common pathogenetic pathway [4] .…”