Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology | Clinical features | Diagnosis | Prognostic factors | Treatment | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Mannan R. Adenocarcinoma-general. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/nasaladenocarcinoma.html. Accessed February 5th, 2023.
Definition / general
- Relatively rare tumor composed of distinctly different morphologic subtypes with variable biologic behavior
Terminology
- Either salivary type or nonsalivary
- Nonsalivary adenocarcinomas are either nonintestinal type or intestinal type, which are further subdivided into low grade or high grade (Head Neck Pathol 2007;1:38)
Epidemiology
- 10 - 20% of all sinonasal malignancies (Am J Surg Pathol 1986;10:192)
Sites
- Adenoid cystic carcinoma usually occurs in maxillary sinus and nasal cavity (Ear Nose Throat J 2002;81:510)
- Ethmoid sinus is the most common location (40%) for nonsalivary gland type adenocarcinoma, followed by nasal cavity (25%) and maxillary antrum (20%) (Head Neck Pathol 2007;1:38)
Etiology
- Exposure to wood dust is risk factor for ethmoid sinus adenocarcinoma (Cancer 1984;54:482)
- Other significant etiologic associations include:
- Alcohol and cigarette smoking (Head Neck 2014;36:1490)
- Formaldehyde (Cancer Causes Control 2002;13:147)
- Leather dust (Acta Otorhinolaryngol Ital 2004;24:199)
Clinical features
- Usually nonspecific clinical findings that mimic benign conditions, including rhinorrhea, nasal obstruction, epistaxis
Diagnosis
- Often delayed due to location and nonspecific symptoms (Otolaryngol Clin North Am 2004;37:473)
- Endoscopic examination usually negative - combination of CT and MRI is optimal
- Biopsy for histologic confirmation
Prognostic factors
- Salivary gland type adenocarcinoma: poor prognosis, patients usually die of local invasion with no metastasis
- Intestinal type adenocarcinoma: usually advanced disease at presentation, poor prognosis
- Low grade nonintestinal type adenocarcinoma: overall favorable outcome
Treatment
- Adequate surgical resection is usual treatment
- Advanced stage disease is treated by surgery and radiation
Microscopic (histologic) description
- Salivary gland type:
- Adenoid cystic carcinoma is the most common subtype, resembles tumor elsewhere
- Nonsalivary adenocarcinomas are either nonintestinal or intestinal type, low grade or high grade
- Intestinal type adenocarcinoma commonly resembles colonic adenocarcinoma
Microscopic (histologic) images
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