8140/3 Adenocarcinoma, NOS


Definitions

Nasal cavity and Sinuses
ICD-O-3 topography code: C30-C31
ICD10: C30-C31
           

A common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.



Colon and rectum
ICD-O-3 topography code: C18-C20
ICD10: C18-C20
           

/span> common, malignant tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous). Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.

Carcinoma of the colon and rectum
A malignant epithelial tumour originating in the large bowel. Metastasis, and therefore the use of the term ?carcinoma? for tumours of the colon and rectum, requires invasion through the muscularis mucosae into the submucosa. More than 90% of colorectal carcinomas (CRC) are adenocarcinomas 1
 
Boyle P, Levin B (eds.)
World Cancer Report.
IARC
Lyon 2008



. Higher rates occur in industrialized, high resource countries (about 40?60 per 100 000), The worldwide mortality rate is about half the incidence rate (about 608 000 deaths from CRC in 2002), but there is wide variation in mortality rates according to available treatment options, with lower rates in countries with high incidences and high resources 2
 
Boyle P, Levin B (eds.)
World Cancer Report.
IARC
Lyon 2008



3
 
Ferlay J, Bray F, Pisani P, Parkin M
Cancer incidence, Mortality and Prevalence Worldwide. Globocan 2002. IARCCancerBase No. 5
IARC: Lyon 2004



. Nonetheless, CRC is the most common cause of deaths from cancer that is not directly attributable to tobacco usage in some of these countries. A high incidence of CRC is observed consistently in populations with a ?Westerntype? diet (highly caloric food rich in animal fat) combined with a sedentary lifestyle. Chronic inflammatory bowel diseases are also etiological factors for CRC 4
Click to access Pubmed
Konda A, Duffy MC (2008)
Surveillance of patients at increased risk of colon cancer: inflammatory bowel disease and other conditions.
Gastroenterol Clin North Am 37: 191-213, viii



5
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Triantafillidis JK, Nasioulas G, Kosmidis PA (2009)
Colorectal cancer and inflammatory bowel disease: epidemiology, risk factors, mechanisms of carcinogenesis and prevention strategies.
Anticancer Res 29: 2727-37



, such as ulcerative colitis, Crohn disease, and Schistosoma mansoni infection 6
Click to access Pubmed
Yosry A (2006)
Schistosomiasis and neoplasia.
Contrib Microbiol 13: 81-100



. Anatomic extent of disease, i.e. tumour stage, is the strongest prognostic factor for CRC. Other prognostic factors include the morphology, lymph node metastases, extend of resection, extramural veinous invasion and genes and biomarkers.

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Stomach
ICD-O-3 topography code: C16
ICD10: C16
           

/span> common, malignant tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).

Gastric carcinomas
Those are malignant epithelial neoplasms accounting for 10% of all cancers world-wide. In all regions, the incidence of stomach cancer is declining but this cancer still represent a significant disease burden in areas with exposure to the main risk factors, Helicobacter pylori infection and high-salt diet. Elder people are preferentially affected. Clinical outcome depends of tumour grade and stage;for 2007, 5-year survival rates of 25%
10
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Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, Kunkler I, (2007)
Recent cancer survival in Europe: a 2000-02 period analysis of EUROCARE-4 data.
Lancet Oncol 8: 784-96



and 27% http://seer.cancer.gov/cgi-bin/csr/1975_2008/results.pl?pagenumbers=542%2C543%2C555 have been reported .

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Esophagus
ICD-O-3 topography code: C15
ICD10: C15
           

A malignant epithelial tumour of the oesophagus with glandular differentiation. These tumours arise predominantly from columnar (?Barrett?) mucosa in the lower third of the oesophagus. Rarely, adenocarcinoma originates from heterotopic gastric mucosa in the upper oesophagus, or from mucosal and submucosal glands
11
 
Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



.
Major risk factors for the development of oesophageal adenocarcinomas are gastro-oesophageal reflux disease (GORD) with associated Barrett oesophagus, obesity and and tobacco smoking. The incidence is rising and in many high-resource countries adenocarcinoma is already more frequent than oesophageal squamous cell carcinoma. Males are preferentially affected.



Gallbladder and extrahepatic biliary tract
ICD-O-3 topography code: C23-C24.0
ICD10: C23-C24
           

/span> common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous). Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.

I - Carcinoma of the gallbladder
This is a malignant epithelial neoplasm, usually with biliary, intestinal, foveolar or squamous differentiation, arising in the gallbladder. Most patients with carcinoma of the gallbladder are in the sixth or seventh decade of life. The incidence of this cancer tend to decrease
12
 
Horner MJ, Ries LAG, Krapcho M, Neyman N, Aminou R, Howlader N et al (eds.)
SEER Cancer Statistics Review
http://seer.cancer.gov/csr/1975_2006/
National Cancer Institute: Bethesda 2009



and varies geographically and also in different ethnic groups within the same country. In the USA, it is more common in American Indians and Hispanic Americans than in whites or African Americans 13
 
Albores-Saavedra J, Henson DE, and Klimstra DS eds.
Tumors of the Gallbladder, Extrahepatic Bile Ducts, and Ampulla of Vater
Armed Forces Institute of Pathology: Washington, DC 2000



14
 
Devor EJ, Buechley RW
Gallbladder cancer in Hispanic New Mexicans II Familial occurrence in two northern New Mexico Kindreds
Can J Genet Cytol 1: 139-145.
1979



15
Click to access Pubmed
Shaffer EA (2006)
Gallstone disease: Epidemiology of gallbladder stone disease.
Best Pract Res Clin Gastroenterol 20: 981-96



. The most important risk factors for carcinoma of the gallbladder are genetic background, gallstones and an abnormal choledochopancreatic junction. The prognosis for patients with carcinoma of the gallbladder depends primarily on the extent of disease and histological type 16
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Albores-Saavedra J, Murakata L, Krueger JE, Henson DE (2000)
Noninvasive and minimally invasive papillary carcinomas of the extrahepatic bile ducts.
Cancer 89: 508-15



17
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Albores-Saavedra J, Vardaman CJ, Vuitch F (1993)
Non-neoplastic polypoid lesions and adenomas of the gallbladder.
Pathol Annu 28 Pt 1: 145-77



18
 
Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



.

> bile ducts. Histologic types, stage of disease, grade, and survival rates.
Cancer 70: 1498-501



25
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Henson DE, Albores-Saavedra J, Corle D (1992)
Carcinoma of the gallbladder. Histologic types, stage of disease, grade, and survival rates.
Cancer 70: 1493-7



26
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Ohtani T, Shirai Y, Tsukada K, Hatakeyama K, Muto T (1994)
The association between extrahepatic biliary carcinoma and the junction of the cystic duct and the biliary tree.
Eur J Surg 160: 37-40



27
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Todoroki T, Okamura T, Fukao K, Nishimura A, Otsu H, Sato H, Iwasaki Y (1980)
Gross appearance of carcinoma of the main hepatic duct and its prognosis.
Surg Gynecol Obstet 150: 33-40



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Histological subtypes>



Esophagogastric junction
ICD-O-3 topography code: Cxx1xx6xx.0
ICD10: C16.0
           

A common carcinoma characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to their growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).

Adenocarcinomas of the oesophagogastric junction (OGJ) straddle the junction of the oesophagus and stomach. This definition includes many tumours formerly called cancers of the gastric ?cardia?. Squamous cell carcinomas that occur at the OGJ are considered to be carcinomas of the distal oesophagus, even if they cross the OGJ
28
 
Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



.
Incidence rates of OGJ adenocarcinomas are higher among Caucasians, in men compared with women, and in the middle-aged and elderly
29
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Keeney S, Bauer TL (2006)
Epidemiology of adenocarcinoma of the esophagogastric junction.
Surg Oncol Clin N Am 15: 687-96



. The incidence of adenocarcinoma of the OGJ appears to be rising in parallel with that of adenocarcinoma of the lower oesophagus 30
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Brown LM, Devesa SS, Chow WH (2008)
Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age.
J Natl Cancer Inst 100: 1184-7



31
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Pera M, Manterola C, Vidal O, Grande L (2005)
Epidemiology of esophageal adenocarcinoma.
J Surg Oncol 92: 151-9



. This is due to common risk factors, i.e gastrooesophageal reflux disease (GORD), overweight/obesity and smoking.






Small intestine
ICD-O-3 topography code: C17
ICD10: C17
           

/span> common, malignant tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous). Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.

Adenocarcinoma of the small intestine
This tumour is rare and mainly seen in the duodenum, especially in the region of the ampulla of Vater. Men are affected slightly more often than women, and the incidence in African Americans is about twice that in Whites
32
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Schottenfeld D, Beebe-Dimmer JL, Vigneau FD (2009)
The epidemiology and pathogenesis of neoplasia in the small intestine.
Ann Epidemiol 19: 58-69



; the median age at manifestation is approximately 67 years. The model of the adenoma?carcinoma sequence is believed to apply to the small intestine as well as the large intestine. Risk factors include chronic inflammation, in particular Crohn and coeliac diseases, smoking and alcohol consumption. Clinical signs include gastrointestinal bleeding and anaemina, bowel obstruction, abdominal pain, vomiting, weight loss, jaundice when located in the region of the ampulla of Vater. They may perforate leading to peritonitis and/or carcinomatosis. The overall 5-year survival reported is 27% 33
 
Key C, Meisner A
Cancers of the esophagus, stomach, and small intestine. In: Surveillance, Epidemiology, and End Results (SEER) Survival Monograph: Cancer Survival Among Adults-US SEER Program, 1988-2001: Patient and Tumor Characteristics
National Cancer Institute: Bethesda, MD 2007



and 30.5% 34
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Howe JR, Karnell LH, Menck HR, Scott-Conner C (1999)
The American College of Surgeons Commission on Cancer and the American Cancer Society. Adenocarcinoma of the small bowel: review of the National Cancer Data Base, 1985-1995.
Cancer 86: 2693-706



and the median survival of 13.9 month 35
 
Key C, Meisner A
Cancers of the esophagus, stomach, and small intestine. In: Surveillance, Epidemiology, and End Results (SEER) Survival Monograph: Cancer Survival Among Adults-US SEER Program, 1988-2001: Patient and Tumor Characteristics
National Cancer Institute: Bethesda, MD 2007



and 19.7 months 36
Click to access Pubmed
Howe JR, Karnell LH, Menck HR, Scott-Conner C (1999)
The American College of Surgeons Commission on Cancer and the American Cancer Society. Adenocarcinoma of the small bowel: review of the National Cancer Data Base, 1985-1995.
Cancer 86: 2693-706



.

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Region of the ampulla of Vater
ICD-O-3 topography code: C24.1
ICD10: C24.1
           

/span> common, malignant tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous). Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.

Adenocarcinoma of the ampullary of Vater
This is a gland-forming malignant epithelial neoplasm, usually with an intestinal or pancreato-biliary phenotype, which originates in the ampulla of Vater. The ampulla may be affected by carcinomas arising from the duodenal mucosa, the distal common bile duct, or the head of the pancreas, but only those carcinomas either centred on the ampulla, circumferentially surrounding it, or demonstrating complete replacement of the ampulla are regarded as ?ampullary carcinoma? for the purposes of classification
37
 
Albores-Saavedra J, Henson DE, and Klimstra DS eds.
Tumors of the Gallbladder, Extrahepatic Bile Ducts, and Ampulla of Vater
Armed Forces Institute of Pathology: Washington, DC 2000



38
 
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, and Trotti A (eds.)
AJCC Cancer Staging Manual
Springer: New York 2009



.

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Anus and anal canal
ICD-O-3 topography code: C21
ICD10: C21
           

A common, malignant tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous). Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.

Adenocarcinoma of the anal canal
This is an adenocarcinoma arising in the epithelium of the anal canal, including the mucosal surface, extramucosal (perianal], the anal glands and the lining of fistulous tracts.

Adenocarcinoma arising in anal mucosa
Most adenocarcinomas found in the anal canal represent downward spread from an adenocarcinoma in the rectum or arise in colorectal-type mucosa above the dentate line. Macroscopically and histologically, they are indistinguishable from ordinary colorectal-type adenocarcinoma, and do not seem to represent a special entity, except for their low location. Adenocarcinoma in the anal transitional zone may develop after restorative proctocolectomy for ulcerative colitis
39
Click to access Pubmed
Sequens R (1997)
Cancer in the anal canal (transitional zone) after restorative proctocolectomy with stapled ileal pouch-anal anastomosis.
Int J Colorectal Dis 12: 254-5



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Extramucosal (perianal) adenocarcinoma
Approximately 200 cases of extramucosal adenocarcinoma have been reported, the largest series unfortunately with insufficient histological data [[5]]. A minimum criterion for diagnosis is an overlying nonneoplastic mucosa, which may be ulcerated. Recent reports indicate that about two thirds of these tumours manifest in men with a mean age of about 60 years. Reliable data for the prognosis for such patients have not been identified. Difficulties in establishing the correct diagnosis may delay proper treatment. Extramucosal adenocarcinomas seem to fall into two groups on the basis of their association with either fistulae or remnants of anal glands. At present, no laboratory methods can distinguish between these two groups. The epithelium of persistent anal fistulae is most often of the same type as that found in the anal glands and anal transitional zone
40
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Lunniss PJ, Sheffield JP, Talbot IC, Thomson JP, Phillips RK (1995)
Persistence of idiopathic anal fistula may be related to epithelialization.
Br J Surg 82: 32-3



, and the epithelia in these two locations show the same profile with regard to mucin composition 41
Click to access Pubmed
Fenger C, Filipe MI (1981)
Mucin histochemistry of the anal canal epithelium. Studies of normal anal mucosa and mucosa adjacent to carcinoma.
Histochem J 13: 921-30



and keratin expression 42
Click to access Pubmed
Hobbs CM, Lowry MA, Owen D, Sobin LH (2001)
Anal gland carcinoma.
Cancer 92: 2045-9



43
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Williams GR, Talbot IC, Leigh IM (1997)
Keratin expression in anal carcinoma: an immunohistochemical study.
Histopathology 30: 443-50



.

Adenocarcinoma within anorectal fistulae
These tumours develop in pre-existing anal sinuses or in fistulae
44
Click to access Pubmed
Anthony T, Simmang C, Lee EL, Turnage RH (1997)
Perianal mucinous adenocarcinoma.
J Surg Oncol 64: 218-21



. Some are associated with Crohn disease 45
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Devon KM, Brown CJ, Burnstein M, McLeod RS (2009)
Cancer of the anus complicating perianal Crohn's disease.
Dis Colon Rectum 52: 211-6



46
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Ky A, Sohn N, Weinstein MA, Korelitz BI (1998)
Carcinoma arising in anorectal fistulas of Crohn's disease.
Dis Colon Rectum 41: 992-6



. Others may contain epithelioid granulomas, often related to foci of inflammation or extravasated mucin, but without other signs of inflammatory bowel disease 47
Click to access Pubmed
Jones EA, Morson BC (1984)
Mucinous adenocarcinoma in anorectal fistulae.
Histopathology 8: 279-92



. Rarely, the tumours may be related to fistulae lined by normal rectal mucosa, including muscularis mucosae, most likely representing adenocarcinomas arising in congenital duplications 48
Click to access Pubmed
Jones EA, Morson BC (1984)
Mucinous adenocarcinoma in anorectal fistulae.
Histopathology 8: 279-92



. Histologically, carcinomas arising in fistulae usually are of the mucinous type, but tubular adenocarcinomas and squamous neoplasia can also be found 49
Click to access Pubmed
Ky A, Sohn N, Weinstein MA, Korelitz BI (1998)
Carcinoma arising in anorectal fistulas of Crohn's disease.
Dis Colon Rectum 41: 992-6



50
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Yeong ML, Wood KP, Scott B, Yun K (1992)
Synchronous squamous and glandular neoplasia of the anal canal.
J Clin Pathol 45: 261-3



.

Adenocarcinoma of anal glands
Only a few cases have been reported in which convincing evidence for origin in an anal gland has been demonstrated by continuity between anal-gland epithelium and tumour
51
Click to access Pubmed
Basik M, Rodriguez-Bigas MA, Penetrante R, Petrelli NJ (1995)
Prognosis and recurrence patterns of anal adenocarcinoma.
Am J Surg 169: 233-7



52
Click to access Pubmed
Hagihara P, Vazquez MD, Parker JC, Griffen WO (1976)
Carcinoma of anal-ductal origin: report of a case.
Dis Colon Rectum 19: 694-701



53
Click to access Pubmed
Parks TG (1970)
Mucus-secreting adenocarcinoma of anal gland origin.
Br J Surg 57: 434-6



54
Click to access Pubmed
WELLMAN KF (1962)
Adenocarcinoma of anal duct origin.
Can J Surg 5: 311-8



55
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Wong AY, Rahilly MA, Adams W, Lee CS (1998)
Mucinous anal gland carcinoma with perianal Pagetoid spread.
Pathology 30: 1-3



. With a single exception 56
Click to access Pubmed
Hagihara P, Vazquez MD, Parker JC, Griffen WO (1976)
Carcinoma of anal-ductal origin: report of a case.
Dis Colon Rectum 19: 694-701



, these patients have had no history of previous or concomitant fistula. The tumours were all characterized by a ductular architecture with scant production of mucin. Pagetoid spread was present in at least one case 57
Click to access Pubmed
Wong AY, Rahilly MA, Adams W, Lee CS (1998)
Mucinous anal gland carcinoma with perianal Pagetoid spread.
Pathology 30: 1-3



. Carcinomas of the anal gland express keratin 7 as well as keratin 5/6 and show a loss of p63 expression, which may be helpful in diagnosis 58
Click to access Pubmed
Hobbs CM, Lowry MA, Owen D, Sobin LH (2001)
Anal gland carcinoma.
Cancer 92: 2045-9



59
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Lisovsky M, Patel K, Cymes K, Chase D, Bhuiya T, Morgenstern N (2007)
Immunophenotypic characterization of anal gland carcinoma: loss of p63 and cytokeratin 5/6.
Arch Pathol Lab Med 131: 1304-11



.

Anal adenocarcinomas without predisposing conditions as described above are rare. They can arise from adenomas [[584A]], which can be graded as for the colorectum.

The prognosis for anal adenocarcinoma seems to be related only to stage at diagnosis and is poorer than that for SCC
60
Click to access Pubmed
Basik M, Rodriguez-Bigas MA, Penetrante R, Petrelli NJ (1995)
Prognosis and recurrence patterns of anal adenocarcinoma.
Am J Surg 169: 233-7



61
Click to access Pubmed
Chang GJ, Gonzalez RJ, Skibber JM, Eng C, Das P, Rodriguez-Bigas MA (2009)
A twenty-year experience with adenocarcinoma of the anal canal.
Dis Colon Rectum 52: 1375-80



62
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Chen YW, Yen SH, Chen SY, Huang PI, Shiau CY, Liu YM, Lin JK, Wang LW (2007)
Anus-preservation treatment for anal cancer: retrospective analysis at a single institution.
J Surg Oncol 96: 374-80



63
Click to access Pubmed
Klas JV, Rothenberger DA, Wong WD, Madoff RD (1999)
Malignant tumors of the anal canal: the spectrum of disease, treatment, and outcomes.
Cancer 85: 1686-93



64
Click to access Pubmed
Myerson RJ, Karnell LH, Menck HR (1997)
The National Cancer Data Base report on carcinoma of the anus.
Cancer 80: 805-15



65
 
Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



.





Prostate gland
ICD-O-3 topography code: C61
ICD10: C61
           

A common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.



Vulva
ICD-O-3 topography code: C51
ICD10: C51
           

A common, malignant tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.

In the vulva, adenocarcinomas may arise at the site of the Bartholin gland
66
Click to access Pubmed
Leuchter RS, Hacker NF, Voet RL, Berek JS, Townsend DE, Lagasse LD (1982)
Primary carcinoma of the Bartholin gland: a report of 14 cases and review of the literature.
Obstet Gynecol 60: 361-8



, the Skene gland 67
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Sloboda J, Zaviacic M, Jakubovskŭ J, Hammar E, Johnsen J (1998)
Metastasizing adenocarcinoma of the female prostate (Skene's paraurethral glands). Histological and immunohistochemical prostate markers studies and first ultrastructural observation.
Pathol Res Pract 194: 129-36



, from endometriosis 68
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Bolis GB, Macciò T (2000)
Clear cell adenocarcinoma of the vulva arising in endometriosis. A case report.
Eur J Gynaecol Oncol 21: 416-7



or from ectopic cloacal tissue 69
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Willén R, Békássy , Carlén B, Bozoky B, Cajander S (1999)
Cloacogenic adenocarcinoma of the vulva.
Gynecol Oncol 74: 298-301



70
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Zaidi SN, Conner MG (2001)
Primary vulvar adenocarcinoma of cloacogenic origin.
South Med J 94: 744-6



. The tumours are usually solid and deeply infiltrative and may be mucinous, papillary or mucoepidermoid in type. Vulvar adenocarcinomas predominantly affect women >50 years of age71
 
Tavassoli FA, Devilee P (Eds.)
World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Breast and Female Genital Organs.
3rd Edition
IARC Press: Lyon 2003



.



Urinary system: Renal pelvis, ureter, bladder, urethra
ICD-O-3 topography code: C65-C68
ICD10: C65-C68
           

Adenocarcinoma is among the most common malignant neoplasm and characterized by the presence of malignant glandular cells. Histologically, adenocarcinomas are classified depending on the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.

In the urinary system, the following variants have been observed:
>Enteric adenocarcinoma
> Mucinous adenocarcinoma
> Signet ring cell carcinoma
> Clear cell adenocarcinoma



Salivary glands
ICD-O-3 topography code: C07-C08
ICD10: C07-C08
           

A common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.



Testis/Male genital organs
ICD-O-3 topography code: C62-C63
ICD10: C62-C63
           

A common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.



Cervix uteri
ICD-O-3 topography code: C53
ICD10: C53
           

/span> common, malignant tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.

Approximately 50% of cervical adenocarcinomas are exophytic, polypoid or papillary masses. Other tumours are nodular with diffuse enlargement or ulceration of the cervix. Tumours that deeply infiltrate the wall produce a barrel-shaped cervix. About 15% of patients have no visible lesion
72
 
Tavassoli FA, Devilee P (Eds.)
World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Breast and Female Genital Organs.
3rd Edition
IARC Press: Lyon 2003



.

>



Bronchus and lung
ICD-O-3 topography code: C34
ICD10: C34
           

A common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.



Ovary
ICD-O-3 topography code: C56
ICD10: C56
           

A common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.



Thymus
ICD-O-3 topography code: C37
ICD10: C37
           

A common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.



Thyroid gland
ICD-O-3 topography code: C73
ICD10: C73
           

A common, malignat tumour characterized by the presence of malignant glandular cells. Morphologically, adenocarcinomas are classified according to the growth pattern (e.g., papillary, alveolar) or according to the secreted product (e.g., mucinous, serous).
Representative examples of adenocarcinoma are ductal and lobular breast carcinoma, lung adenocarcinoma, renal cell adenocarcinoma, hepatocellular carcinoma, colon adenocarcinoma, and prostate adenocarcinoma.