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Colonoscopy Biopsy Result

Posts: 19
Joined: Aug 2014

Hi. Colonoscopy on 8/18/14. I had three polyps and one mass between 3 to 4 centimeters. GI said the mass was colon cancer right after the colonoscopy. However, GI sent biopsies of the polyps and the mass to a lab. I spoke with GI yesterday. The lab results indicate that the polyps were precancerous. The mass was identified as an intramucosal adenocarcinoma. The biopsy of the mass was sent to Columbia for a second opinion. CAT scan results not back yet.


1. Can a biopsy from a colonoscopy be enough for a lab to identify the entire mass as an intramucosal adenocarcinoma?


2. Of course I do not want any form of cancer, but from what I read an intramucosal adenocarcinoma is a better version than the other various possibilities. Is that correct?


3. If the biopsy identified the sample an an intramucosal adenocarcinoma, is it more likely than not that the cancer has not spread outside the colon wall and to the lymph nodes, liver or lungs?


3. Is it typical for a lab to send a biopsy out for a second opinion? If not, under what circumstances would this occur? If one lab identified a biopsy of a mass in the colon as a intramucosal adenocarcinoma, what would lead that lab to send the biopsy out for a second opinion? Would it be more probable that they feel it may be noncancerous or is it more probable that they feel it is a more invasive form of cancer?  Someone told me that it is standard practice for labs to send out biopy results to other labs for second opinions.


Easyflip's picture
Posts: 588
Joined: May 2013

That sounds pretty hopeful to me. From what I remember intramucosal means it's in the mucosal layer and has not breached the colon wall which is good. My path report also graded the cells as well or poorly differentiated, well differentiated being better. They base your treatment on a host of factors so I'm not sure what's next for you, maybe that's it, fingers crossed! Some of your questions you should ask your doc as we here are not fully trained.
I'm all for second opinions, I've had docs tell me totally different things. If they're competent they welcome second opinions, I guess that's where the 'art' of medicine comes in. Good luck. And keep us posted.

Posts: 19
Joined: Aug 2014

Hi EasyFlip:

I am hoping that the biopsy sample from the colonoscopy showing the sample cells as intramucosal adenocarcinoma means that the tumor in its entirety is only made up of those cells. I will need to have surgery to remove this tumor and resect my colon.  The GI thinks it can be done laparoscopically.  I am still waiting on the CAT scan results and hoping that it does not show liver or lung involvement.  I guess after the surgery they will decide if chemotherapy is warranted.  I have two appointments with board certified colon rectal surgeons scheduled and I am setting up a third.  I also made an appointment with an oncologist, in the event that I do need chemotherapy.  The GI suggested getting this tumor removed within 2 weeks if possible.  I asked the GI if he thought I could be cured of this cancer, and he said yes, as did my primary care physician, so I feel hopeful about that.

Nana b's picture
Nana b
Posts: 3045
Joined: May 2009

It's unusual from them to use the word cured, especially when they don't know what stage you are yet. 


I hope they caught it early, I really do, but the word Cured, is seldom used.   I had a golf ball size tumour that had already spread to my liver.   I was staged at 3, then at 4. 


Wishing you the best, may it be Stage 1!  Stay hopeful, &  stay strong. 

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