CYSTADENOCARCINOMA (cysta-denocarcinoma; Greek kystis a bubble + an adenocarcinoma) — a malignant tumor like ferruterous cancer, coming from an epithelial vystilka of a cyst or forming a cystous cavity in the course of the development.
C. most often meets in ovaries where it can be bilateral (see Ovaries, tumors). Much less often the cystadenocarcinoma is observed in a pancreas, sialadens (is more often than parotid) and mammary glands.
In ovaries distinguish a serous and mucinous cystadenocarcinoma.
Serous cystadenocarcinoma (synonym: the serous tsistokartsinoma, a ma-lignizirovanny serous cystoma, a malignizirovanny tsilioepite-lialny cystoma, seroanaplastiche-Skye a carcinoma, a psammomatozny carcinoma, ovarian cancer of a serous structure) is observed at women at the age of 40 — 60 years having primary and secondary infertility, an inflammation of appendages of a uterus. Among malignant tumors of ovaries serous C. makes about 60 — 80%. The tumor arises generally at the expense of a malignancy of an epithelium of oothecomas.
Macroscopically the tumor has an appearance of brittle papillary or solid growths in a cavity of cysts of ovaries or on their outside wall, there can be multitsentrichesk in several cameras of cystadenomas. It is microscopically characterized by the expressed proliferation of an epithelium with formation of papillary and ferruterous structures. In the thickness of a tumor psammozny little bodies often are found (see). Serous C. it is characterized by rapid growth with distribution on the next bodies, innidiation in limf, nodes, an epiploon, a peritoneum, internals.
Mucinous cystadenocarcinoma (synonym: cancer from a pseudomucinous cyst, an adenopapillyarny carcinoma, a volfova an epithelioma, a pseudomucinous cystadenocarcinoma) makes apprx. 10% of all malignant tumors of ovaries.
It is macroscopically characterized by existence of compact sites of the breaking-up tumor in the thickness of separate cameras of cysts of ovaries or papillary growths on an outer surface of these cysts. Microscopically this tumor consists of the atypical polymorphic cells forming papillary, ferruterous, lattices. Psammozny little bodies meet seldom. In late stages of a disease metastasises extend on a peritoneum, lymphatic and to blood vessels.
The disease proceeds asymptomatically in the beginning, and only later there are complaints to abdominal pains, ascites develops (see). Dysfunctions of intestines are often noted that is shown in the form of locks or ponos, feeling of discomfort in an abdominal cavity.
At a palpation of a stomach and vaginal examonation in a lower part of an abdominal cavity the tumor of an uneven consistence can be defined; its palpation is quite often painful. Tumoral nodes can come to light also in rectovaginal deepening. In diagnosis of a tumor an important role is played a gynecologic research (see), a laparoscopy (see Peritoneoskopil) with a possible biopsy, an irrigosko-piya (see), a kolonoskopiya (see), urography (see), a X-ray analysis in the conditions of a pneumoperitoneum (see), ultrasonic investigation (see. Ultrasonic diagnosis), a computer tomography (see the Tomography computer), a cytologic research (see) the contents of an abdominal cavity received at a puncture through a back vault of the vagina.
The puncture of a tumor is not recommended to be carried out.
The treatment which is preferential combined (see Tumours, treatment). As a rule, it is begun with an operative measure, at Krom it is desirable to remove whenever possible a uterus with appendages, a big epiploon. In the subsequent carry out treatment by antineoplastic means (see). Use Cyclophosphanum, Tio-TEF, 5-ftoruratsit, a methotrexate, adriamycin, drugs of platinum. The combined chemotherapy is more effective, than use of separate antineoplastic drugs. Radiation therapy is applied rather seldom. The remote gamma therapy or intraperitoneal administration of radioactive colloid gold 198ai can be used.
The forecast depends on a stage of development of a tumor and degree of its differentiation. Five-year survival averages 30 — 35%.
Prevention consists in timely recognition and removal of benign tumors and oothecomas.
Bibliography: Clinical oncology, under the editorship of H. N. Blochina and B. E. Peterson, t. 2, page 490, M., 1979; To r and e in with to and I am I. S., Cancer of an ovary, M., 1978; H e h and e in and I. D.» treatment of tumors of ovaries, L., 1972,
bibliogr.; Pathoanatomical diagnosis of tumors of the person, under the editorship of N. A. Krayevsky, etc., page 273, M., 1982; With ER about in S. F. and With to and l of l and R. E. Histologic classification of tumors of ovaries, International histologic classification of tumors, No. 9, M., 1977; In a r b e r H. R. To. Ovarian carcinoma, N. Y., 1978; Gynecologic oncology, ed. by M. Coppleson, v. 2, N. Y., 1981; Novak E. R.a. Woodru ffj. D. Novak’s gynecologic and obstetric pathology, Philadelphia a. o., 1979. V. P. Kozachenko.