One of the most common types of malignant neoplasms is adenocarcinoma. With this type of tumor, cancer cells begin to grow from the glandular epithelium, which is part of most glands of internal organs.
There are many causes of adenocarcinoma, they are generally divided into general and specific. Treatment should be started as early as possible, the outcome of the disease depends on it. What is adenocarcinoma?
Adenocarcinoma is a malignant neoplasm whose growth begins with the mutation of glandular epithelial cells.
Epithelium with glandular cells lining the inner surface of almost any organ and is the main building material of the human glands.
Epithelial cells are found in the skin, so the glandular type of cancer affects the skin of the body.
A special feature of adenocarcinoma is considered the development of a growing tumor of mucous or serous secretions. Subdivided adenocarcinomas by microscopic localization of cells. The emerging tumor can be either solid or containing separate cysts.
Classification of
Adenocarcinomas are classified by the histological structure of the mutated cells.
Highly differentiated
This form of adenocarcinoma is characterized by the presence of glandular cells, devoid of sharp atypism and lined with single-layered epithelium. The size of the cells is increased, the nuclei are elongated and monomorphic.
Moderately differentiated
There is a significant increase in atypical cells, individual parts of the tumor combine into complexes that resemble squamous cell carcinoma in structure. Similarity with this type of cancer is intensified and certain destructive changes in the tumor.
Low-differentiated
This form of adenocarcinoma contains cells characterized by characteristic signs of their malignancy. Atypical cells are difficult to attribute to a specific tissue, which makes it difficult to establish their structure.
A low-grade tumor in the early stages causes metastasis.
Species at the place of formation
Mucinous
The structure of this type of adenocarcinoma is represented by clusters of epithelium and impregnations of mucus-like mucin in them.
This type of tumor is considered to be one of the most rare types of cancer, its boundaries are poorly expressed. The tumor consists of cystic cavities filled with a jelly-like viscous liquid, the color of the surface of the lesion is grayish, closer to white.
Histological examination of mucinous adenocarcinoma reveals fuzzy neoplastic cells that are found in the mucin secret. The islets between the cells are connective tissue. Atypical cells can be cubic, cylindrical and have hyperchromic nuclei.
Mucinous cancers are most often localized in the intestine, characterized by a large production of mucus.
Mucinous adenocarcinomas are practically insensitive to irradiation, due to which an unfavorable prognosis of their course is exposed.
After treatment, relapse is possible, metastases primarily affect regional lymph nodes.
Light-celled
Distinguished by a high degree of malignancy, it affects the urino-genital organs of women. Light-cell adenocarcinoma in the medical literature is indicated by a number of other terms - mesonephroma, meso-neural, meson-fungal or meso-nephrogenic cancer.
In a macroscopic study, it was found that most of the new formations of this form have a polypoid shape and consist of several types of cells:
- Polygonal, endowed with a glycogenized cytoplasm in abundant amounts. These cells have a central or eccentric nucleus.
- Flattened.
- Nailing.
- Polygonal, having oxyphilic cytoplasm.
In histology, the tumor structure has papillary, solid and tubular-cystic cells. The produced mucin accumulates in the lumen of the glands.
Light-cell adenocarcinomas accumulate membrane material, which is termed stromal hyalinization.
Endometrioid
One of the most common signs of this type of cancer is uterine bleeding, occurring in almost 90% of patients with this diagnosis. In addition to this trait, a dense formation is found in the lower abdomen, and early on the common signs of a cancerous lesion develop - fatigue, weakness, pain.
Endometrioide adenocarcinoma is found in more than 70% of cases at an early stage of its development and as a result, almost complete recovery is achieved.
Several provoking factors have been revealed, under the influence of which endometrial adenocarcinoma develops most often, it is:
- Diabetes mellitus.
- Obesity.
- Later onset of menopause,
- Uncontrolled intake of estrogens and oral contraceptives.
Fine-Acid
This type of tumor is divided into large and small tumors.
The onset of a tumor begins in the lobules of the prostate gland, they accumulate a secret emerging from the neoplasm through the excretory canals. Small-tumor tumors from large differ only in size.
The growth of the neoplasm causes the prostate to cover the bladder. It is possible to transfer cancer cells to the prostate, genito-urinary organs, and the digestive tract is under threat of infection.
Acinar adenocarcinoma does not lead to changes in the analyzes, it can be detected only by histological examination of a sample of altered tissues. The probability of the spread of abnormal cells throughout the body is increased, metastasis often occurs in the lymph nodes and abdominal cavity.
Acinar adenocarcinoma is divided into three forms:
- With the first form, the growing onco-tumor does not go beyond the boundaries of the adenoma.
- With the second form in contact with the prostate gland.
- With the third form growing in the adenomatous node.
The most unfavorable prognosis in the third form, as it is not amenable to therapy. On development, the neoplasm may indicate the appearance of unusual changes and sensations in the prostate gland.
Papillary
This kind of adenocarcinoma is endowed with papillary growths, which is what the second name of papillary oncology is associated with - papillary.
Sprouts protrude into the lumen of the cystic cavity or gland. The origin of a cancerous tumor begins with the formation of papillae in the fluid.
Papillary adenocarcinoma differs in different structure and size, it can affect almost any human organ, but still it is most often found in the tissues of the thyroid gland, in the ovaries and in the kidneys.
The defeat of the thyroid gland is also indicated by another term - the cell-cell carcinoma, which occurs in most cases in children and women in middle age. Histologically, large papillae show papillate protrusions, the tumor parenchyma reaches large sizes and consists of a highly cylindrical epithelium with signs of atypia and polymorphism.
Between the papillary ingrowths in the cavities of the follicles, resorbed vacuoles are found. Neoplasms of thyroid gland are endowed with a moderately or poorly developed connective tissue base.
Papillary adenocarcinoma can consist of psammose corpuscles, their structure is represented by calcified and basophilic masses, which are never present in papillary adenomas. Similar psammoznye bodies are rarely found and with other forms of adenocarcinoma thyroid.
Macroscopically have a globular shape, cyanotic or brown hue, elastic consistency and cystocapillary structure. The lymphoid tissue can remain in the center of the growing node under the capsule.
Serous
Can affect both one and both ovaries at once. The serous fluid produced by the tumor is similar to that produced by the epithelial layer of the fallopian tubes.
The neoplasm is a multi-chambered cystic structure that can reach huge dimensions.
Active development of cancer cells and rapid growth of the formation leads to the fact that the tumor sprouts through the capsule, metastasizes into a group of other organs and passes to a large omentum. This causes a disruption in the functioning of the omentum, which in turn causes a pathological disruption in the functioning of the circulatory and digestive systems.
Metastases with serous adenocarcinoma develop in all layers of the peritoneum, while fluid accumulates in the abdominal cavity, that is, ascites occur.
Serous tumor cancers are found in 75% of patients with epithelial ovarian cancer.
Endocervical
Adenocarcinoma, localized in the cervix, is rare. Most often, the cervical canal is affected by squamous cell carcinoma.
Microphoto of endocervical cervical adenocarcinoma
The formation of an endocervical tumor begins with an atypical change in mucus-producing cells, the neoplasm may have an exophytic or endophytic growth pattern. With endophytic spreading of the tumor, it deepens towards the uterus. Exophytic tumors spread to the vagina.
Endocervical adenocarcinoma can persistently leak for a long time, in some women a history of spotting is revealed in an anamnesis. The diagnosis is established by examining a smear for the detection of oncocells( Pap test).
Dark-celled
This type of oncology has one distinctive feature: when carrying out histological staining, atypical cells absorb a lot of coloring material and thereby darken strongly.
Dark-cell adenocarcinomas are found in the organs of the abdominal cavity, in the prostate gland.
Meibomian adenocarcinoma
This term refers to the oncology of the glands located in the cartilaginous tissue of the eyelid. Most often, the disease is found in women at the age of closer to 50 years.
Neoplasm grows under the skin, visually looks like a knot of yellowish color. Often, this form of adenocarcinoma is confused with halazion, which after removal or drug therapy begins to grow aggressively. Therefore, after excision of the chalazion, histology of the tissues is necessarily performed.
If the neoplasm is only within the eyelids, then external irradiation is performed.
Metastasis is observed in the parotid and submandibular lymph nodes.
Adenocarcinoma of this form is distinguished by a high degree of malignancy, after surgical treatment and irradiation relapses in the coming years are observed in almost 90% of patients.
Within 5 years, most of the patients die from the development of distant metastases.
Reasons for
Allocate common and specific causes of adenocarcinoma. The last group includes those that are characteristic of a cancer-struck organ.
Common causes of
The study of adenocarcinomas allowed us to establish that most often the mutation of epithelial cells is caused by the stasis of the secretion of glands with their subsequent inflammation.
This can be provoked:
- Irrational power.
- By exposure to radioactive radiation.
- Chronic pathologies.
- Contact with certain types of chemicals.
- Long-term smoking.
- Infection with papillomavirus.
Allocate and hereditary predisposition to the development of adenocarcinoma.
Specific causes of
The growth of adenocarcinomas in certain organs is also due to the structure and functioning of these body systems.
- The formation of adenocarcinoma of the intestine is caused by chronic constipation, colitis, polyps, villous tumors, fistula.
- Carcinoma of the esophagus often occurs after thermal burns and against the background of permanent injuries with pieces of poorly chewed food.
- Liver adenocarcinoma begins to form against the background of infections and parasitic diseases.
- Kidney damage occurs against the background of glomerulonephritis or pyelonephritis.
- Bladder adenocarcinoma is caused by stagnation of urine, chronic cystitis, leukoplakia.
Symptoms of
The symptoms of adenocarcinoma are divided into three periods:
- The first period is hidden, that is, the disease is practically not manifested. Can only be observed periodic weakness, increased fatigue, minor and fast-paced pain.
- In the second period, oncological signs appear due to the localization of the tumor.
- In the third period, soreness develops where the tumor is localized, signs of impaired functions of a particular organ appear. At this stage, lymph nodes increase, and metastasis occurs.
Esophagus
Adenocarcinoma of the esophagus is characterized by development:
- Dysphagia , that is, uncomfortable sensations when swallowing saliva and food lumps.
- Single asphyxia - painful swallowing.
- Increased salivation of , which occurs due to narrowing of the esophagus due to the growing formation.
Salivary gland
Cancerous formation most often affects the gland on one side. First, a dense stationary formation begins to form without clear boundaries. Further growth leads to:
- Appearance of soreness.
- Impaired mobility of the jaw.
- Discomfort when chewing.
- Puffiness and hyperemia of the skin.
Liver
To specific signs of liver adenocarcinoma include:
- Decreased appetite.
- Nausea, vomiting.
- Anemia.
- Appearance of uncomfortable sensations and pains on the right under the ribs or in the stomach.
- Increase in liver size or the appearance of a growing node.
- Nasal bleeding.
- Increased temperature.
- Accumulation of fluid in the abdominal cavity.
- Jaundice sclera and skin.
Cecum
If the caecum is affected, the patient may be troubled:
- Frequent constipation or vice versa diarrhea.
- Periodic soreness in the lower abdomen.
- Frequent tenesmus, that is, false urges to emptying the intestine.
- Symptoms of anemia.
- Bleeding, manifested as the presence of blood impurities in feces.
- Subfebrile temperature.
- Poor appetite and aversion to meat dishes.
In later stages, intestinal obstruction, ascites, is possible.
Thyroid gland
Adenocarcinoma of thyroid gland manifested:
- Difficulty in swallowing and breathing.
- The soundness and change of the voice's voice.
- Shortness of breath.
- The appearance of a tumor-like neck strain.
Bladder
An early sign of cancer of the bladder is considered to be hematuria - the appearance of blood in the urine, which leads to its pinkish coloration.
In the future there are such symptoms as:
- Pain in the groin, the perineal region. Initially, they occur with a bladder overflow.
- Painful urination.
- Total hematuria, leading to the release of blood clots and is the cause of anemia.
Against the backdrop of adenocarcinoma of the bladder, cystitis often develops, acute pyelonephritis, there may be an attack of the type of renal colic.
Metastases
Metastasis of abnormal cells in adenocarcinomas occurs by the flow of lymph or blood.
In most patients with adenocarcinomas, the primary focus is difficult to identify in order to correctly diagnose a comprehensive examination is appointed. The multiplicity of secondary foci worsens the prognosis of the course of the disease.
Diagnosis
Adenocarcinomas are easier to treat at the earliest stages of their development, for their detection, an appropriate examination should be assigned.
Which diagnostic procedures will be chosen depends on the patient's complaints, examination, and objective changes in the functioning of the organs.
The general and biochemical analysis of blood, urinalysis, establishment of oncomarkers are mandatory.
Neoplasms in internal organs are detected using:
- Radiography.
- ultrasound scanning.
- Different types of tomography.
- Endoscopy examinations.
The malignancy of the detected pathological focus can be established by histological examination of the biopsy specimen.
Treatment and prognosis of tumor
The method of treatment of a patient with adenocarcinoma is selected based on the localization of cancer education, its stage, the presence of metastases, the age of the patient.
The most favorable prognosis can be set if it is possible to prescribe combined methods of treatment, that is, a combination of surgical removal of the tumor with chemotherapy and radiation exposure sessions.
During surgery, not only the tumor itself is removed, but also surrounding healthy tissue that is necessary to prevent the further development of cancer cells.
The use of chemotherapy after surgery makes it possible to destroy the remaining atypical cells in the body. Chemotherapy and radiotherapy can be used as palliative methods to facilitate the patient's well-being in the event that surgical intervention is impossible in the last stages of the disease.
All types and forms of adenocarcinoma are successfully treated, provided they are detected at the earliest stages.
If the neoplasm is already diagnosed with the presence of a large number of secondary foci, then such patients live less than 6 months.