Adenocarcinoma is cancer that starts in glandular tissue. It can affect organs like the colon, breasts, lungs and pancreas.
Adenocarcinoma often doesn’t have symptoms and may only be found by chance on x-ray or CT scans taken for another reason. It can also be diagnosed by blood tests or a biopsy.
Adenocarcinoma starts in glandular epithelial cells, which line the inside of organs and secrete mucus or digestive juices. This type of cancer can occur almost anywhere in the body, including the lung, stomach, colon, intestine, ovary, pancreas and breast. It can also spread to other parts of the body, where it’s called metastatic adenocarcinoma.
A number of factors increase your risk of developing adenocarcinoma. They may be genetic, environmental or both. If you have one or more of these risk factors, it’s important to talk to your doctor about them. He or she can help you understand your risk and suggest ways to lower it.
Hereditary mutations (changes in the DNA) are associated with several types of adenocarcinoma, particularly those of the colon and intestine. These include familial adenomatous polyposis, Lynch syndrome and the biallelic MUTYH, BRCA1/2, PALB2, CDKN2A, TP53 and FAP mutations.
Smoking and exposure to secondhand smoke can greatly increase your risk of lung adenocarcinoma. This is because the chemicals in cigarette smoke can damage your lungs, which can make it more likely that you will develop adenocarcinoma there.
Other risk factors include a family history of adenocarcinoma and certain medical conditions like ulcerative colitis and diabetes. The type of cancer you have and your age also affects your risk.
Some adenocarcinomas grow more quickly and are more likely to spread to other parts of the body than others. The cancer’s grade, which describes how different the cancerous cells look under a microscope, is also an important factor in predicting how fast the tumor will grow and whether it will spread.
Metastatic adenocarcinoma most often spreads to the bones, lungs and liver, but can spread to any tissue in the body. The cancer can also travel through the bloodstream or lymph system to reach other areas of the body. For example, adenocarcinoma of the lungs can spread to the brain. It can also spread to lymph nodes in the neck, abdomen and groin. The type of lymph nodes the cancer reaches determines what kind of treatment you might need. This is why it’s important to have regular physical exams, so doctors can check for problems like adenocarcinoma.
Cancerous cells grow out of control and may spread to other parts of the body, a process called metastasis. Adenocarcinoma is a type of tumor that develops in glandular tissue, or tissues that line organs and secrete mucous, digestive juices, and other liquids. The cells in glandular tissue are part of a larger category of tissues called epithelial, which also includes skin, intestinal and uterine tissue, and the lining of the eyes and ears.
Many people who have adenocarcinoma do not experience any symptoms, especially when the tumor is still small. Some adenocarcinomas can be detected on a CT scan or chest X-ray that is done for screening or another reason. If a person has symptoms, such as a lump or cough that will not go away, the doctor should be consulted right away.
The signs and symptoms of adenocarcinoma depend on the area of the body where the cancer is found and the underlying cause. For example, adenocarcinoma that forms in the glandular tissue of the lungs is known as non-small cell lung cancer (NSCL). In this type of cancer, adenocarcinomas form in the cells that line the lungs and usually begin in the outer layers.
Other types of adenocarcinoma include:
Stomach cancer – more than 90 percent of stomach cancers are adenocarcinomas and develop in the cells that line the inner surface of the stomach.
Pancreatic cancer – almost all pancreatic cancers are adenocarcinomas, which start in the cells that line the pancreatic duct and sometimes spread to other areas of the body.
Breast cancer – the most common type of breast cancer, invasive ductal carcinoma, is a form of adenocarcinoma that occurs in the glandular tissue in the breasts.
If a doctor suspects that you have adenocarcinoma, several diagnostic tests may be needed to confirm the diagnosis. These tests often include a biopsy, which is the removal of a sample of tissue for examination under a microscope. The results of the biopsy help the doctor determine if the cancer is localized or metastatic, and what treatment is needed. Other tests that are used include computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography/CT (PET).
Cancer occurs when your cells start to grow out of control and destroy healthy tissue around them. They can be confined to the organ where they started or can spread to other areas of your body, such as the lymph nodes or bones. Adenocarcinoma is a specific type of carcinoma that starts in glandular tissue. These tissues line the skin, glands or cavities of organs, such as the liver and kidneys. There are different types of adenocarcinoma, depending on which area of the body is affected and whether the cancer has spread to other parts of your body.
You may be diagnosed with adenocarcinoma when you visit your doctor to discuss symptoms like pain or other unusual changes in your body. Your doctor will do a physical exam and feel your organs to check for swelling or abnormal growths. They can also detect adenocarcinoma during regular screening tests such as mammograms or colonoscopies. The most common way to diagnose adenocarcinoma in the lungs is through routine imaging tests called chest X-rays or CT scans. Other testing methods may be used to diagnose adenocarcinoma of the colon, oesophagus or pancreas.
Your doctor will take a sample of your tissue and send it to a lab for further evaluation. They will look at the tissue under a microscope to determine whether or not you have adenocarcinoma and what kind. You may also be given other tests to help make the diagnosis, including bloodwork and a biopsy.
If your adenocarcinoma has spread, it will likely show up on your lab tests as metastatic cancer. Your doctor will use the information from your previous medical history, current symptoms and results of your initial evaluation to recommend treatment options for you.
The most common type of adenocarcinoma in adults is lung adenocarcinoma, which accounts for about 85% of non-small cell lung cancers (NSCL). It usually begins in the outer layer of your lungs. It can also form in the oesophagus, where it is most commonly linked with Barrett’s Oesophagus. Adenocarcinoma of the stomach is rare but can affect up to 90 percent of people with gastric cancer.
Adenocarcinoma is a cancer that starts in glandular tissue. It can be found throughout the body and it often forms in organs that have glands, including the liver and kidneys. The five-year relative survival rate varies by the type of adenocarcinoma and where it started. For example, esophageal adenocarcinoma has a much lower survival rate than breast adenocarcinoma because it is more common in older people and it is usually discovered after it has spread to other parts of the body.
Some adenocarcinomas do not cause any symptoms at all and are only detected by regular tests such as mammograms or colonoscopies. This is why it is important to get regular screenings.
If adenocarcinoma is detected, the healthcare professional will need to take a sample of tissue for testing. This can be done using a needle or by surgically removing part or all of the tumor. The sample will then be sent to a lab for further testing.
The results of the test will help the doctor decide on a treatment plan. The treatment plan may include surgery, chemotherapy, radiation or other therapies. The patient’s overall health and the site of the adenocarcinoma will also play a role in the decision making process.
Surgery is one of the most common treatments for adenocarcinoma. The type of surgery will depend on the location of the tumor and whether it has spread.
For adenocarcinoma of the skull base, the preferred surgical procedure is the Endoscopic Endonasal Approach (EEA). This minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors. This helps reduce the time needed to heal after surgery and the risk of complications.
If the adenocarcinoma has spread to other parts of the body, it is considered stage 4. The doctor will measure how deeply the cancer has grown into nearby tissue and check for signs that the cancer has spread to lymph nodes in other areas of the body. The staging system used is TNM, which stands for tumor, lymph nodes and metastases.
After treatment, the doctor will want to know if the adenocarcinoma recurred. Regular tests will be done to watch for signs of cancer, such as new lumps or changes in the size of existing tumors.
If your doctor suspects you have adenocarcinoma, they will ask you to get regular screening tests. These can help them detect the cancer before it spreads too far. They may also do a biopsy to find out how much the cancer has grown. This information helps doctors decide on your treatment.
Cancer is a disease that happens when cells in the glands that line your organs grow out of control and harm healthy tissue. It can be a terrifying diagnosis, but it’s important to remember that many patients do not experience any symptoms. Weight loss is a common side effect of adenocarcinoma, but it may not be the only symptom you experience.
Your organs have glandular cells that produce fluids your body needs to function properly. Adenocarcinoma develops when these cells grow out of control. It can form in many areas of the body, including the colon, lungs, breasts, esophagus, pancreas and prostate. The specific risk factors for adenocarcinoma vary, but smoking and exposure to harmful toxins are commonly associated with the condition.
When adenocarcinoma forms in the colon or other gastrointestinal organs, it typically causes diarrhea or abdominal pain. However, it may also cause other signs, such as a large, painful lump or a loss of appetite. In some cases, adenocarcinoma may spread to other areas of the body, especially when it forms in the lungs. This type of cancer is often diagnosed with a chest X-ray or CT scan that is performed for another reason.
Spread of adenocarcinoma occurs when cancer cells break off and travel through the bloodstream or lymph system to other parts of the body. This process is sometimes referred to as “adenocarcinoma metastasis.”
Adenocarcinoma can be diagnosed using several tests, depending on the location of the tumor. For example, a biopsy can be used to obtain a sample of the tissue for testing. A biopsy can be done with a needle or through an endoscopy, which involves inserting a scope in the gastrointestinal tract. The biopsy results will help doctors determine the exact type and stage of adenocarcinoma.
Loss of appetite as a result of cancer or its treatment can make it hard to get the nutrients your body needs. It can also be a sign of a more serious health problem, like malnutrition or wasting syndrome (also called cachexia).
The type and location of the tumor can help determine how bad your loss of appetite is and whether it’s temporary or permanent. For example, cancers that grow in glands near the mouth or throat may interfere with chewing and swallowing. Lung adenocarcinoma often develops in the lining of the esophagus, and pancreatic cancer typically starts in the ducts that make hormones and enzymes that digest food.
Cancers can also spread by breaking off and traveling through your bloodstream or lymph system to other parts of the body. These new locations are called metastases. Adenocarcinoma can spread to any part of the body where there are glands, but it’s most common in the colon, breast, and lungs.
Your doctor will want to take a sample of the area where you think you have cancer to look at under a microscope. This is called a biopsy. They may also use a CT scan or an MRI to see the affected organ and check for abnormal masses. This information helps doctors decide what your treatment will be. It can include surgery, chemotherapy or radiation therapy, and other treatments. The type of treatment will depend on where the adenocarcinoma is and how far it has grown. It will also depend on the type of adenocarcinoma you have, which is based on how abnormal the cells look under a microscope. Adenocarcinomas with well-differentiated cells grow and spread more slowly than those with poorly differentiated cells.
Adenocarcinoma is a type of cancer that starts in the glands that line the insides of your organs. It can happen in the colon, breasts, esophagus, lungs or pancreas. The cancer may grow quickly or slowly and spread to other parts of your body. Treatments include chemotherapy, radiation and surgery.
Your doctor may give you anti-nausea drugs to help with this. You can also try changing what and when you eat. Choose bland foods like Jell-O, toast and crackers and avoid spicy or fatty foods. Eat small meals often throughout the day and sip liquids, such as tea or juice. Try not to overdo it on the fluids, because dehydration can make you feel worse.
You may also have nausea and vomiting that doesn’t respond to medicine. It is important to let your doctor know about your symptoms and ask for help. This may help you feel more comfortable and continue your treatment as planned.
Some people have a harder time dealing with the emotional effects of their diagnosis and treatment. Your friends and family can be a good source of support and offer practical advice. You can also join a support group and meet other people who have the same diagnosis as you.
Some cancer treatments, such as chemotherapy and radiation therapy, can cause nausea and vomiting. The treatment area, your previous medical history and the dose of the medication can affect how sick you will feel. You can also have anticipatory nausea and vomiting before your next chemotherapy session begins. The smells and sights of the treatment room can remind you of an earlier episode of sickness and trigger this symptom. Talk to your doctor if this happens and see if there are things you can do to reduce your symptoms, such as using relaxation techniques or taking an anti-anxiety drug.
If adenocarcinoma develops in the colon or rectum, it can cause diarrhea. This is because cancer cells can interfere with the way your body digests food. They may also block the intestines, which leads to watery or loose stools. The diarrhea can be worse after chemotherapy or immunotherapy treatments (ipilimumab and nivolumab).
Some types of adenocarcinoma have no symptoms in the early stages. This is especially true for lung adenocarcinoma, which can take many years to develop and doesn’t usually cause symptoms until it is very advanced. Adenocarcinoma in the pancreas, breasts or prostate often doesn’t produce any symptoms until it is very advanced as well.
Your doctor can diagnose adenocarcinoma by doing a physical exam and feeling your organs. They can also check for signs of cancer, such as a lump or mass, by doing tests like a CT scan or an MRI. They can also use a procedure called a biopsy to remove a sample of the tissue and test it under a microscope to see if it’s cancerous.
If you have cancer and are experiencing diarrhea, talk to your doctor right away. It’s important to have the condition checked because it can be a sign of another health problem or a side effect of your treatment. Your doctor can give you tips to manage your diarrhea, such as drinking lots of liquids and eating foods that are low in fiber (e.g., rice, applesauce and bananas). They can also recommend other treatments to help relieve your diarrhea. You can also find support from other patients who have adenocarcinoma on our forum. This is a great way to connect with others who understand what you’re going through and offer advice or inspiration.
Cancer is a disease that occurs when cells no longer obey the tightly regulated system that dictates when they grow, mature and die. Cancerous cells continue to reproduce indiscriminately and damage healthy tissue in the area they invade. Adenocarcinoma forms in glandular tissues that line organs like the colon, breasts, pancreas and esophagus. Adenocarcinoma may also form in the lungs, where it can cause pain, coughing or blood in the sputum.
Because adenocarcinoma can occur in so many different parts of the body, the symptoms vary. However, if you notice any of the following signs and symptoms, talk to your doctor right away.
Fatigue is a common symptom of adenocarcinoma because cancer takes up the body’s nutrients to grow and advance. This drains the body’s reserves, leading to fatigue and other health problems, such as a low-grade fever or iron deficiency anemia.
Adenocarcinoma can spread locally to nearby tissue, and it may spread through the bloodstream to distant areas of the body. Some types of adenocarcinoma are more likely to metastasize, depending on where they begin and how advanced they are.
The first step in diagnosing adenocarcinoma is getting a biopsy. During a biopsy, a medical professional removes a sample of the cancerous tissue and examines it under a microscope. A biopsy can determine if the cancer has spread or not. After a biopsy, you can receive treatment to prevent the cancer from spreading or returning. Common treatments include surgery, chemotherapy, and radiation. Chemotherapy involves using drugs to kill cancerous cells and stop them from growing. Radiation uses high-energy X-rays to kill cancer cells or slow their growth. In addition to these treatments, you might need hormone therapy if the tumor was caused by hormone receptors, such as in the case of estrogen-positive breast cancer or androgen-positive prostate cancer.
Cancer cells often spread to other parts of the body through the bloodstream or lymph system. Cancers that have spread are called metastatic adenocarcinoma and are usually named for the organ where they began, such as breast cancer that has spread to the lung.
A doctor can diagnose adenocarcinoma by taking a sample of tissue from the affected area and testing it for cancer cells. The results determine the stage of the cancer.
When adenocarcinoma is in the lung, doctors often remove it with surgery. They may also take tissue from the area around the tumor to test for cancer cells, a process called a biopsy. The tissue will help doctors find out how far the cancer has spread. This helps doctors decide what type of treatment you need.
The surgeon will also look at your medical history. They will ask about things like whether you’ve ever had any other health problems and if you smoke or used to smoke. They will also order a number of tests, such as blood work, an imaging test or a colonoscopy. These tests can tell the doctor if you are healthy enough for surgery.
Before the operation, a nurse or doctor will ask you to drink plenty of fluids and not eat anything for several hours before surgery. This is because having food or liquids in your stomach can cause vomiting during and after the operation. They will put you under anesthesia or a sedative, so you won’t feel the surgery.
They will also shave the area that is to be operated on and start an IV (an intravenous line) so they can give you medicine through it. Then the doctor will make a small incision and remove the cancer or part of it. They will send the tissue to a lab to be tested for cancer cells. The lab will also show how much cancer has spread, which is known as staging.
You might need to stay in the hospital for a few days after the surgery. You will probably get a visit from a home healthcare aide or a rehabilitation facility to help you after you leave the hospital. Check with your insurance company about coverage for these services.
After the surgery, you will likely get chemotherapy to kill cancer cells that are left. You might also need radiation therapy to shrink the tumor. The doctor will use high-energy X-rays or other types of radiation to kill the cancer cells. Sometimes doctors combine these treatments with other types of treatment.
Adenocarcinoma is a cancer that starts in glandular cells that line your organs. These cells secrete mucous and digestive juices. Usually, the cells don’t become cancerous, but sometimes they do. Adenocarcinoma can grow in any of the glandular cells that line your body’s organs, including those in your lungs, colon, breasts, pancreas, and esophagus. It’s the most common type of these types of cancer, and it can spread to other parts of your body.
Symptoms vary depending on the part of your body that is affected. For example, adenocarcinoma of the lung may cause coughing and difficulty breathing. Adenocarcinoma of the breast may cause pain in your chest or nipple and bloody fluid leaking from your nipple. It can also affect your digestive tract, causing a blockage of the intestine or stomach.
A healthcare provider can diagnose adenocarcinoma by taking a sample of an abnormal mass and examining it under a microscope. They may also take a biopsy of the area around the tumor. During this procedure, the healthcare provider inserts a needle into the mass to extract a small piece of tissue, which they then examine under a microscope.
They use a test called immunohistochemistry to look for a certain protein in the cells. This test tells them if the cancer is high or low grade. A higher-grade cancer is more likely to spread to other parts of your body.
Doctors can treat adenocarcinoma with chemotherapy alone or in combination with other treatments, such as radiation therapy or surgery. They may also give you a drug that targets specific proteins on cancer cells and stops them from growing or spreading. This is called targeted therapy.
Chemotherapy can have many side effects, so your care team will help manage them. They might give you medications to prevent or ease nausea, vomiting, mouth sores, or other problems. They might also give you a drug that helps your body absorb chemotherapy more effectively. They might also give you a drug to protect your liver or bone marrow from the damage caused by chemotherapy. They might also give you a medication to lower your risk of infection.
Radiation therapy sends beams of radiation to kill cancerous cells, which can also shrink tumors. It may be used alone or in combination with surgery and chemotherapy.
Your doctor will decide on your treatment based on the stage of the adenocarcinoma, and where it is located. The stages are based on how abnormal the cancer cells look under a microscope. Well-differentiated adenocarcinomas are considered low grade, and grow and spread slower than poorly differentiated ones.
Adenocarcinoma may spread to other areas of the body before it is diagnosed, called metastasis. Your doctor will evaluate the stage and location of the cancer to determine if it is metastatic.
To treat adenocarcinoma, your doctor will probably use radiation therapy. You will lie on a table while the machine makes a buzzing sound and moves around you to reach different areas of your body. Your doctor will connect with you via video and audio to give you instructions during your session.
The radiation targets the DNA in cancerous cells, which causes them to die or to become unable to reproduce. It is possible for radiation to damage healthy cells as well, but usually not enough to cause significant side effects. Normal cells can repair their DNA more easily than cancerous ones, so the goal of radiation therapy is to destroy as many cancer cells as possible while minimizing harm to healthy tissue.
In addition to external radiation, doctors can also use internal radiation (brachytherapy). Small radioactive seeds are implanted into the tumor or surrounding tissue, where they release a dose of radiation over time.
These seeds can be placed directly into the cancer or inside an organ, like the liver or lungs. They can also be inserted into the bloodstream to reach more distant cancerous tissues.
An adenocarcinoma is cancer that grows in the glands that line your organs. It can occur in many different parts of your body, including your colon, breasts, esophagus, pancreas, and lungs. It’s the most common type of cancer in some of these places.
Most of the time, adenocarcinoma doesn’t cause symptoms in its early stages. The condition can be hard to diagnose, especially in places like the lungs or pancreas. A symptom of adenocarcinoma is often pain or bleeding, but it can also be fatigue or weight loss.
To diagnose adenocarcinoma, your doctor may need to perform a biopsy or other medical tests. During a biopsy, your doctor removes a small piece of tissue from the affected area for testing. This can be done using a needle or a tube inserted into the area, such as an endoscopy. A biopsy can help determine if the cancer is adenocarcinoma or another type of cancer.
Other tests to help determine if you have adenocarcinoma include CT scans, which provide images of the inside of your body, and ultrasounds, which are similar to ultrasounds but are used on bigger areas of the body. A biopsy can also show if the cancer has spread. Your doctor will use a classification system called TNM (tumor, nodes, and metastasis) to tell how far the cancer has spread. N indicates if the tumor has spread to nearby lymph nodes. M shows how far the cancer has spread throughout the body, and if it has metastasized to other organs.
Your doctor may also check for adenocarcinoma by doing a physical exam and asking about your health history. He or she will feel your abdomen and other parts of your body for any swelling or growths. If you’re at risk for adenocarcinoma because of your family history or lifestyle factors, your doctor will ask about these as well. For example, smoking increases the odds of getting adenocarcinoma in the esophagus, colon, or pancreas. It’s also more common in men than in women, and it’s more likely to affect older people. You’re also more likely to get adenocarcinoma if you’ve had other types of cancer or have certain genetic conditions.
Adenocarcinoma starts in cells that line or cover parts of organs. These cells are called epithelial tissue.
Well-differentiated adenocarcinomas tend to look more like glandular tissue and spread slower than poorly differentiated ones.
A doctor can diagnose adenocarcinoma by taking a sample of tissue from the affected organ and looking at it under a microscope. This is called a biopsy. A biopsy can also show whether the cancer has spread from another part of the body.
A rare gynecologic malignancy, endometrial carcinoma (type 1 endometrioid cancer or endometrioid adenocarcinoma) is usually low grade, found at a localized stage and has a favorable prognosis. It can present as a solid, lobulated lesion in the pelvic organs or as an enlarged uterus. The carcinoma may infiltrate the ovaries and/or the peritoneum. It most frequently occurs in postmenopausal women, but can also occur in peri- and premenopausal women with hyperestrogenism, especially those with endometriosis. It is thought to be associated with unopposed estrogen stimulation and hormonal imbalances (obesity, polycystic ovarian disease or other causes of chronic anovulation, and the use of hormones including tamoxifen). A subgroup of this type of tumor has been identified as “dedifferentiated” carcinoma. The tumor cells display solid patternless growth and a worse clinical course than high-grade endometrioid adenocarcinoma. Those with the DEAC component should not be underdiagnosed as conventional endometrioid cancer and should be further categorized in order to provide intensive treatment to improve patient survival.
A third type of gynecologic cancer is uterine sarcoma, which is different from endometrial cancer because it forms in the muscle wall of the uterus, a hollow, muscular organ in the lower part of a woman’s pelvis where a fetus grows. Like other types of sarcoma, uterine sarcoma can be found in both pre- and postmenopausal women, but is more common in older women.
Cancers are classified according to the staging system of the FIGO International Union for Cancer Working Group, which describes how much the cancer has spread within the uterus and to other organs. Staging is important because it helps doctors plan treatment. Doctors use tests and procedures to find out how far the cancer has spread, so they can treat it effectively. For example, a woman with stage I endometrial cancer has a hysterectomy, an operation to remove the uterus, before the cancer can spread to other parts of her body. A cancer that has reached stage IV has spread to the rectum, bladder and possibly other organs. See the PDQ summary on Uterine Sarcoma for more information about this cancer.
Mucinous carcinomas are tumors that contain cancer cells in a gelatinous substance called mucin. These cancers can form in any part of the body that produces mucus, including the lungs, colon and rectum. They may be mixed with noncancerous cells, or consist of only cancerous cells, which is called pure mucinous carcinoma. The survival rate for mucinous carcinomas depends on the area of the body affected and the type of mucinous cancer.
Mucinous adenocarcinoma of the lung, formerly called mucinous bronchioloalveolar carcinoma, is one of the rarest forms of lung adenocarcinoma. This tumor has been reported to have poor prognosis in comparison to other adenocarcinomas of the lung. Several cases of this cancer have been misdiagnosed, because mucinous adenocarcinomas can present with similar radiological findings to pneumonia. These characteristics make it difficult to distinguish these tumors on computed tomography (CT) images, and the patient may have a worse clinical course due to incorrect treatment.
The mucinous component of these tumors has been shown to have distinct clinicopathological, molecular, and radiologic features compared to the nonmucinous component. Moreover, the extracellular mucinous components appear to have a different response to chemotherapy and radiation therapy, as well as a different metastasis pattern. Several mutations in mucinous adenocarcinomas have been identified, including microsatellite instability and a higher frequency of KRAS mutations compared to non-mucinous adenocarcinoma.
The authors of a recent study concluded that mucinous colorectal cancer has a different molecular and radiologic profile than nonmucinous colorectal adenocarcinoma and should be considered as a separate disease subtype. They also found that patients with mucinous colorectal cancer had more extensive recurrence, more frequent peritoneal metastasis, and a lower survival rate than those with non-mucinous colorectal adenocarcinoma. However, the authors acknowledge that their study was limited by the small size of their sample and the lack of a formal comparison group. Future studies with larger samples and more detailed follow-up will help to determine the true survival rate of this disease subtype. These results may improve neoadjuvant and adjuvant treatment for these patients. This could be achieved by focusing on the complete removal of these tumors using improved standards of total mesorectal excision.
Clear cell carcinoma of the uterus and cervix is often associated with prenatal exposure to diethylstilbestrol (DES). DES was given to pregnant women in high-risk pregnancy and was used in the US from 1938 to 1971 and internationally until the early 1980s. DES can cause a number of abnormalities including endometriosis, vaginitis and adenocarcinoma of the uterus and cervix. Several studies have shown that clear cell adenocarcinoma of uterus and cervix can be prevented with adequate folic acid intake, judicious use of birth control pills during pregnancy and discontinuation of DES before conception.
The histogenesis of clear cell adenocarcinoma is not well understood. Some authors suggest that it is of Mullerian epithelial origin, and others argue that it may develop in ovarian surface epithelium or in the fallopian tubes (endosalpingiosis). The clear cell histologic pattern has unique biological features that distinguish it from other epithelial ovarian cancers.
It has a distinct glycogen phenotype and characteristic hobnail cells that are easily recognized on microscopic examination. However, because it is similar in appearance to renal and hepatic clear cell carcinomas and metastatic clear cell cholangiocarcinoma of the liver, differential diagnosis with these tumors can be difficult.
In addition, clear cell adenocarcinoma can be confused with serous adenocarcinoma of epithelial origin (SCA) of the ovary. SCA can be distinguished from CCC by the presence of thick papillae, cellular stratification and budding, enlarged nuclei, and marked nuclear pleomorphism. In addition, SCA is frequently accompanied by cytoplasmic hyaline granules and is typically perivascular with a prominent sinusoidal vascular framework not seen in CCC.
Clear cell adenocarcinoma has also been reported in the urinary bladder, particularly as a result of cystic endometriosis. In these cases, it is generally associated with a higher risk of hyperplasia and ectopic urethral tissue formation than non-clear cell neoplasms. However, it is also associated with lower rate of recurrence and improved survival compared to other histological subtypes.
A mesonephric carcinoma is a rare malignant tumor with histologic features similar to endometrial adenocarcinoma. However, it typically develops from the mesonephric remnants of the uterus. There are only two reports in the literature of a mesonephric carcinoma that included a sarcomatous component and both occurred in postmenopausal women. This is a unique cytologic and immunohistochemical entity that needs to be recognized as a distinct disease.
Mesonephric adenocarcinoma rarely metastasizes to the pelvic organs. This neoplasm usually presents as abnormal vaginal bleeding or as a cervical mass on pelvic examination. Most cases of mesonephric adenocarcinoma are located deep in the lateral cervical stroma and are not related to human papillomavirus (HPV) infection. This type of tumor can be diagnosed by biopsy or endometrial curettage, as well as on hysteroscopy or hysterectomy specimens.
The hematoxylin-eosin staining of mesonephric adenocarcinoma demonstrates a solid architecture with glandular elements and occasional tubules containing luminal eosinophilic colloid-like material. In addition, most cases of mesonephric cytology demonstrate a diffuse PAX8 positivity and focal GATA3 positivity. On the other hand, mesonephric adenocarcinomas that have metastatic spread to the lung usually show a diffuse FGFR2 expression and a focal expression of TTF1 expression.
A 55-year-old female presented with postmenopausal bleeding and underwent dilation and curettage. The resulting pathology report from another institution indicated poorly differentiated endometrial adenocarcinoma with a sarcomatous component in the uterine cavity. The patient then underwent a total hysterectomy at our institution. Three years later, she developed pulmonary nodules and was treated with platinum-based chemotherapy and tyrosine kinase inhibitors with a favorable response.
This is the first case of mesonephric adenocarcinoma with an FGFR2 mutation in the cervical area and the second report of metastatic mesonephric carcinoma to the lungs. This rare disease process should be identified and treated similar to other cervical adenocarcinomas in order to increase clinical knowledge of this neoplasm and ultimately enhance treatment strategies.