Adenoma is a benign tumor of epithelial origin and which has glandular characteristics. It may arise from any glandular organ in the body and may rarely transform into a malignant adenocarcinoma.
An adenoma is a benign epithelial tumor with glandular origin, glandular characteristics, or both. It may become malignant and can also appear in non-glandular areas. The malignant transformation is rare. It may cause of other complications such as compressive symptoms and autonomous hormone secretion . The adenomas may be at different levels of dysplasia, with the ones with more dysplastic characteristics, having more potential for malignant transformation.
An adenoma occurs due to an abnormal cell proliferation and defective apoptosis. There are believed to be multiple steps in the progression from normal tissue to adenoma, and then ultimately to adenocarcinoma. The processes differs from site to site and involve loss of tumor suppressor genes and activation of oncogenes. Some of these genetic aberrations may be genetically passed down like in familial adenomatous polyposis (FAP), some may be due to external carcinogens.
The epidemiology of adenomas varies from site of origin. The list is not exhaustive:
The biochemical processes that lead to adenoma formation depend on the location and the underlying cell type. There may be an interplay of genetic and environmental factors with organs exposed to the environment being at higher risk. The tumorgenesis for many of these is just beginning to be elucidated.
The prognosis varies from the site, but the grade of dysmorphic cells and dysplasia is prognostic, with high grades being more prone to malignant transformation than lower grades. There are some familial adenoma syndromes such as familial adenomatous polyposis which is known to have a high propensity for malignant transformation.
The presentation may depend on the site:
The workup is dependent on the site of the adenoma and the symptoms that it is causing.
The treatment of an adenoma will depend entirely on the location and other symptoms caused by the tumor. Many are asymptomatic and will never require any treatment or follow-up. The symptomatic ones may require surgical removal.
Since most are caused by cell proliferation, it is difficult to prevent adenomas. The important aspect it to find the ominous ones early and treat them appropriately to prevent malignant transformation. Families with a strong family history of adenomas like colonic polyps will require screening.
Adenomas are small swellings that can occur in many locations in the body. Most of them are innocent, but some may cause trouble if they are big enough and compress nearby structures. They have a small potential to become cancers.
The cause of the growths is unknown, but there is ongoing research into genetics with information growing.
These depend on the site. In the brain there may be headache and problems with eye site. If they are in the colon there may be constipation or diarrhea otherwise most are asymptomatic. Adrenal tumours may secrete hormones that may cause different symptoms such a weight gain and diabetes if corticosteroid are being made, or episodes of palpitations and flushing if adrenaline is being made. Thyroid adenomas may cause a disease called hyperthyroidism which is presents with heat intolerance and weight loss. Parathyroid adenomas may present with symptoms of too much calcium in the body such as aches and stomach pains.
Diagnosis is dependent on the site, for the brain a CT scan or magnetic resonance imaging may be used. For the colon a colonoscopy. For adrenal adenomas a CT scan and blood tests to check hormone levels may be done. The same for parathyroid adenomas. For thyroid adenomas an ultrasound may be required and a small piece taken for testing.
The response of your doctor will depend on the site and the symptoms and the local guidelines. They may requiring occasional screening or removal by surgery if required.