Adenocarcinoma

Adenocarcinoma is a salivary-gland epithelial malignancy with varied architecture and no residual pleomorphic adenoma component. It accounts for 9% of salivary epithelial tumors and is relatively high-grade. It may grow in acinar, papillary, bronchioloalveolar or solid patterns, often with mucin production (requiring special stains, especially in poorly differentiated tumors). Because adenocarcinoma is infiltrative, wide excision is required. Nodal metastasis reaches 36-47%, so radical or selective neck dissection is performed with primary resection; sacrificing the facial nerve may be necessary. Intraoperative frozen sections are used to check margins.

Common Symptoms

Chest pain; ataxia; hemoptysis; blood-streaked sputum; chest tightness; paroxysmal cough; vertigo

Causes

Caused by environmental/chemical pollution, ionizing radiation, free-radical toxins, microbes and their metabolites, work/lifestyle factors, genetics, endocrine imbalance and immune dysregulation leading to malignant transformation of normal cells. Grossly: round/oval, mostly unencapsulated, medium-firm, gray-white cut. Microscopically: marked cellular atypia, varied architecture — solid nests, cords, glandular lumens, tubular/adenoid structures; glandular patterns indicate higher differentiation and lower malignancy. Biology: highly infiltrative and destructive, readily invading vessel/lymphatic walls, giving hematogenous and lymphatic spread. Gross: peripheral lung location, clear borders, associated fibrosis and pleural retraction; may cross pleura to chest wall; gray-white with hemorrhage/necrosis; mucinous tumors show glistening myxoid areas. Microscopy: glandular lumens with mixed well/poorly differentiated components; intracellular mucin needs mucicarmine or PAS; papillary/tubular patterns; rare clear-cell, signet-ring and spindle-cell variants. Must be distinguished from mesothelioma; cells are relatively uniform, larger with high N:C ratio, prominent eosinophilic nucleoli, and mucin vacuoles.

Treatment

Surgery; drug therapy; physical therapy; supportive care

Prevention

No effective prevention; early detection and treatment are key.

Recommended Department

It is recommended to visit the oncological surgery department; before the visit you may first book an appointment and connect with experts through this platform.

Warm reminder: The above information is provided for health education reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek care at a regular hospital in time.