acinar cell carcinoma
Introduction
Introduction to acinar cell carcinoma Acinar cell carcinoma (also known as serous celladenocarcinoma). Before the 1950s, acinar cell carcinoma was considered to be a type of parotid tumor. It was first described by Foote and Frazell in 1953. And named, Buxton made the tumor have malignant properties, WHO named it acinar cell tumor, but the clinical manifestations often have recurrence and metastasis, and most of them are currently considered to be low-grade malignant tumors. basic knowledge The proportion of illness: 0.005% Susceptible people: no specific population Mode of infection: non-infectious Complications: lymphoma
Cause
The cause of acinar cell carcinoma
Fistula epithelial cell lesions (50%)
The cell morphology of the tumor is completely similar to that of the acinar serous cells, so it is considered that acinar cell carcinoma occurs in acinar cells, but there are fistula cells in the lesion, and there is a transition from fistula cells to acinar cells, so the gland is considered The vesicular cell carcinoma is derived from the fistula epithelium.
Scar tissue carcinogenesis (35%)
The theory that peripheral adenocarcinomas occur in scar areas associated with tuberculosis or infarction or other damage has been around for a long time. The concept of scar cancer suggests that precancerous lesions change in the scar area and cause cancer. However, some researchers have suggested that scars are secondary to cancer.
Prevention
Acinar cell carcinoma prevention
The recurrence rate of acinar cell carcinoma is 20% to 55%, the lymph node metastasis rate is 3% to 11%, and the distant metastasis rate is 10% to 12%. Although there is a tendency to metastasize and local infiltration, it is in the salivary gland tumor. Among them, the malignant degree of acinar cell carcinoma is lower, and the general prognosis is better. The 5-year cure rate is above 88%. Eneroth et al reported that the tumor was 5 years, and the 15-year survival rate was 90% and 68%, respectively. After 5 years, 10 years, 15 years, the cure rate was 76%, 63%, 55%, and the local recurrence rate was 33%. Domestic Zhang Xiaoshan reported 5 years, 10 years, 15 years survival rate was 95.83%, 83.35. %, 60%, the recurrence rate was 37.14%.
Complication
Acinar cell carcinoma complications Complications lymphoma
The recurrence rate of acinar cell carcinoma is 20% to 55%, the lymph node metastasis rate is 3% to 11%, and the distant metastasis rate is 10% to 12%. The cause of tumor recurrence is multifaceted, and conservative tumor resection is performed. The rate of local recurrence was 66.7%, of which 22.2% died of tumor recurrence. For partial salivectomy, the local recurrence rate was 9.5%.
Symptom
Acinar cell cancer symptoms common symptoms tumor cell infiltration growth slow nodules
Acinar cell carcinoma is a rare tumor of the parotid gland, accounting for 1% to 3% of salivary gland tumors, accounting for 1% to 4% of large salivary gland tumors, and 5.1% to 12% of salivary gland tumors. According to the Garder report, it accounts for 7% to 15% of the malignant tumors of the large salivary glands. The site of the parotid gland is the most common, almost unique to the parotid gland, but it occurs in the submandibular gland, the sublingual gland and the small parotid gland. Juveniles can develop from the elderly to the elderly, but they are most common in 40 to 60 years old, and women are more common than men.
Acinar cell carcinoma is clinically similar to mixed tumors, often painless masses, occasionally pain and facial nerve involvement, and the course of disease is longer, ranging from several months to several decades. The tumors are mostly round and substantial. There are nodules, medium texture or slightly hard, a few cystic changes, activity, no adhesion to the skin, advanced metastasis, cervical lymph node metastasis is the most common.
Examine
Examination of acinar cell carcinoma
Auxiliary examinations include parotid angiography, CT, B-mode ultrasound, and radioisotope scanning, but the diagnosis is based on pathological examination.
(A) General form: The tumor is round or oval, most of which are non-enveloped but incomplete. The texture is medium hardness and the cut surface is grayish white.
(B) microscopic examination: tumor cells are distinctly shaped and have different structures. Some are solid clumps or small strips, some of which can be seen as glandular cavities, some in a tubular or adenoid structure. It is generally considered that those with a glandular structure have a higher degree of differentiation and a lower degree of malignancy. The connective tissue between the small strips and the small masses is uncertain. Many of them are similar to hard cancers. The interstitial is small and the cancer cells are called soft cancer.
(3) Biological characteristics: Adenocarcinoma has high infiltration and destructive growth characteristics. Adenocarcinoma is easy to invade blood vessels and lymphatic wall, and there are more blood and lymphatic metastasis.
Diagnosis
Diagnosis and differentiation of acinar cell carcinoma
The clinical manifestations of acinar cell carcinoma are similar to those of pleomorphic adenoma and are easily misdiagnosed as mixed tumors. However, acinar cell carcinoma is mostly located in the parotid gland, which is hard and may have painful symptoms in some cases.
After the pathological biopsy is clearly diagnosed, no identification is required. Adenocarcinoma is a malignant tumor of the parotid epithelium with different structures but no residual pleomorphic adenoma. Adenocarcinoma accounts for 9% of parotid epithelial tumors and belongs to a higher degree of malignancy in parotid malignant tumors.
