cystadenocarcinomas

Cystadenocarcinoma is a malignant epithelial tumor that arises from the lining of a cystic lesion and is capable of invasive growth and metastasis. The term is used for cystadenocarcinomas occurring in several organs, most commonly the ovaries and the pancreas, but also in the biliary tract and other sites. These tumors typically originate from preexisting cystic neoplasms and may display serous, mucinous, or papillary architectures depending on their tissue of origin.

Clinical presentation varies by organ and stage. Ovarian cystadenocarcinomas often present with a pelvic mass, abdominal distension, or nonspecific symptoms; pancreatic or biliary forms may cause abdominal pain, weight loss, jaundice, or malaise. Imaging with ultrasound, computed tomography, or magnetic resonance can reveal complex cystic masses with septations, nodules, or papillary projections. Tumor markers such as CA-125 may be elevated in ovarian tumors, while CEA or CA 19-9 can be raised in pancreatic or biliary lesions.

Diagnosis is confirmed by histopathology showing malignant epithelial cells with invasion of the surrounding stroma. Immunohistochemistry can aid classification, with ovarian serous tumors commonly expressing WT1 and PAX8, and mucinous tumors showing CK7 with variable CK20. Grading and stage determine prognosis and treatment options.

Treatment is primarily surgical, aiming for complete removal when feasible. In ovarian cystadenocarcinoma, procedures may include salpingo-oophorectomy with staging and, depending on patient factors, hysterectomy; adjuvant chemotherapy is commonly used for higher-stage disease. Pancreatic and biliary cystadenocarcinomas are usually managed with surgical resection, with adjuvant therapy chosen based on stage and histology. Prognosis depends on stage at diagnosis and tumor biology, with early-stage disease carrying a better prognosis than advanced disease.