How do we stage acellular mucin in lymph nodes of colorectal cancer specimens without neo-adjuvant therapy?

Abstract

The prognosis and adjuvant treatment of patients with colorectal cancer (CRC) is pivotally dependent on the identification of positive nodal metastatic disease in resected specimens. Whilst the presence of acellular mucin (ACM) at the primary tumour site in patients who have shown complete pathological response after neoadjuvant therapy (NT) for rectal cancer, has been reported as having no impact on oncological outcome¹, local recurrence² and survival^1,2,3,4, less clear is the impact of ACM found within lymph nodes (LN) in patients who have not had NT. We present our encounters with two such patients and discuss the implications of this rare phenomenon.

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