Adenocarcinomas – Summary
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There are two varieties of adenocarcinomas I'd
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like to refer you to with regard to the salivary glands.
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The first is that which occurs within the gland
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itself, which is usually occurring in minor
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salivary gland tissue or can occur in the parotid
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gland and this will favor the palate as are most
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of the minor salivary gland neoplasms.
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Its five-year prognosis is pretty poor at only
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46%, and there may be squamous infiltration
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adenosquamous varieties of these carcinomas.
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The second is the salivary ductal carcinoma, which
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is a variety of adenocarcinoma that is again a
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relatively aggressive-looking tumor that can
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infiltrate the glandular tissue
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as well as the ducts.
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Now,
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I had previously shown you a case of squamous cell
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carcinoma of the duct which is thought to be due to
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change in the
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the adenomatous tissue via metaplasia to squamous cell
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and then from squamous metaplasia to squamous
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cell dysplasia and carcinoma. In this case,
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this is an adenocarcinoma affecting
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the salivary gland ductal tissue.
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Here is an example of
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two cases of adenocarcinoma,
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one involving the parotid gland,
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which has that typical dark signal
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intensity on T2-weighted scan.
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So, T2-weighted scan, parotid gland relatively bright,
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that cancer being quite dark,
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and this would probably be one that I would be
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concerned has a high nucleus-to-cytoplasm
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ratio and therefore a low ADC value.
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And here is another one. You're getting used to
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probably seeing the hard palate cancers,
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in this case, an adenocarcinoma grows into the inferior
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aspect of the maxillary antrum
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from the hard palate. Again, rising from minor
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salivary gland tissue of the hard palate.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
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