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Adenocarcinoma in situ and minimally invasive adenocarcinoma are the earliest forms of lung cancer of the adenocarcinoma type: small tumours, usually seen as ground-glass spots on a CT scan, that have not yet invaded, or have invaded less than five millimetres. When removed they are effectively cured, with no recurrences in the large series, so the question is how little surgery is enough.
The IASLC/ATS/ERS classification introduced adenocarcinoma in situ (a solitary adenocarcinoma of 3 cm or less with pure lepidic growth along intact alveolar walls) and minimally invasive adenocarcinoma (the same with an invasive component of 5 mm or less) in place of the term bronchioloalveolar carcinoma, and the WHO classifications of 2015 and 2021 keep both entities and stage them by invasive size only (Travis 2011; Nicholson 2022). They present as ground-glass or part-solid nodules on CT.
How it differs from its parent: outcome. In 1,038 stage I adenocarcinomas, none of the 36 patients with adenocarcinoma in situ or minimally invasive adenocarcinoma recurred, lepidic predominant invasive tumours had a five-year cumulative recurrence of 8 percent, and non-lepidic tumours 19 percent (Kadota 2014). In 524 resected cases in Japan (65 percent women, 64 percent never-smokers, mean tumour diameter 15.2 mm, 44 percent treated by sublobar resection) there was no recurrence over a median follow-up of 100 months, and the clinical problem was second primary lung cancers rather than relapse (Yotsukura 2021).
How common: about 11 percent of lung cancers coming to resection in the Japanese series (Yotsukura 2021); a growing share where CT screening is used.
Treatment: surgical removal, increasingly by sublobar resection (wedge or segmentectomy) rather than lobectomy, with no adjuvant therapy; the parent's resectable page holds the trials of sublobar surgery for small peripheral tumours (CALGB 140503, JCOG0802). Small pure ground-glass nodules are often watched on CT before any surgery.
Of 1,038 resected stage I adenocarcinomas at Memorial Sloan Kettering, 2 were adenocarcinoma in situ and 34 minimally invasive (Kadota 2014); of 4,768 lung cancer resections in Japan between 1998 and 2010, 524 (11 percent) were one or the other (Yotsukura 2021).
Central tumours arise in the large airways, peripheral ones in the alveoli; both drain to hilar then mediastinal nodes, and the pleural lining is a separate cancer site.
Same organ: Mediastinal germ cell tumour, Pleuropulmonary blastoma (types I, Ir, II and III), Type A and type AB thymoma, Type B1 and type B2 thymoma, Type B3 thymoma, Micronodular thymoma with lymphoid stroma, Adenocarcinoma of the lung, Squamous cell carcinoma of the lung, Large cell carcinoma of the lung, Sarcomatoid carcinoma of the lung, Adenosquamous carcinoma of the lung, Invasive mucinous adenocarcinoma of the lung, Basaloid squamous cell carcinoma of the lung, Lymphoepithelial carcinoma of the lung, Pulmonary blastoma (adult), Non-small-cell lung cancer, Lung cancer (all types), Small-cell lung cancer, Mesothelioma, Pleural mesothelioma, Thymoma and thymic carcinoma, Childhood lung and airway tumours (pleuropulmonary blastoma, tracheobronchial tumours), Inflammatory myofibroblastic tumour (IMT), EGFR-mutated non-small-cell lung cancer, ALK-positive non-small-cell lung cancer, KRAS G12C-mutant non-small-cell lung cancer, ROS1-positive non-small-cell lung cancer, MET exon 14 and MET-amplified non-small-cell lung cancer, RET fusion-positive non-small-cell lung cancer, BRAF V600E-mutant non-small-cell lung cancer, HER2-mutant non-small-cell lung cancer, NTRK fusion-positive non-small-cell lung cancer, PD-L1-high non-small-cell lung cancer without a driver mutation, Resectable stage I to III non-small-cell lung cancer, Unresectable stage III non-small-cell lung cancer, Limited-stage small-cell lung cancer, Extensive-stage small-cell lung cancer, Lung neuroendocrine tumours (typical and atypical carcinoid), Thymoma (WHO types A, AB, B1, B2 and B3), Thymic carcinoma
Surgical resection, sublobar where the tumour is small and peripheral, with no adjuvant therapy; the parent's resectable page holds the sublobar-surgery trials.
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Query for this cancer: (TITLE:"Adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung" OR ABSTRACT:"Adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung" OR TITLE:"Adenocarcinoma in situ of the lung" OR ABSTRACT:"Adenocarcinoma in situ of the lung" OR TITLE:"AIS" OR ABSTRACT:"AIS" OR TITLE:"Minimally invasive adenocarcinoma" OR ABSTRACT:"Minimally invasive adenocarcinoma" OR TITLE:"MIA" OR ABSTRACT:"MIA" OR TITLE:"Lepidic adenocarcinoma, preinvasive" OR ABSTRACT:"Lepidic adenocarcinoma, preinvasive") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Adenocarcinoma in situ and minimally invasive adenocarcinoma of the lung, not a curated reading list.
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