Presentation
Case presentation A 34-year-old man with no history of systemic disease presented with fever; he had lost 8 kg during the week before presentation. Physical examination revealed no significant findings. [ncbi.nlm.nih.gov]
Compared with the normal mammary tissue, EAN presents with benign hyperplasia of lactiferous ducts and the disorganized growth of two types of epithelial cells. [dovepress.com]
Pregnancy is not contraindicated, but if HCA larger than 5 cm are present, they should be resected before conception [1]. [karger.com]
Clinical presentation Adenomyomatosis per se is usually asymptomatic. It is, however, frequently associated with chronic biliary inflammation, most commonly gallstones (25-75%), but also seen in cholesterolosis (33%) and pancreatitis. [pacs.de]
Entire Body System
- Inflammation
Pathological tests revealed extensive inflammatory cell infiltration and caseous-like necrosis consisting of chronic granulomatous inflammation with acute necrotizing inflammation. [ncbi.nlm.nih.gov]
The incidence increases with age, presumably the result of protracted inflammation (see below). There is a female predilection (M:F=1:3). It is most often an incidental finding and usually requires no treatment. [pacs.de]
Sinclair et al. [10] described the case of a woman with important systemic inflammatory symptoms and biochemical signs of inflammation related to hepatic inflammatory adenomas which resolved after OCP cessation. [karger.com]
- Swelling
[…] women, typically in fourth and fifth decades of life, and extremely less in men and children.1,4 The tumor is usually unilateral and asymptomatic, and the common clinical symptoms are erosion, serous discharge (serous and/or sanguineous), nodularity, swelling [dovepress.com]
Workup
Colonoscopy
- Polyps
(cholesterol polyp) cholesterolosis: mucosal hyperplasia with the accumulation of cholesterol esters and triglycerides in the lamina propria macrophages (cf. intraluminal accumulation seen in adenomyomatosis) cholelithiasis papillomatosis Exclusion of [pacs.de]
(cholesterol polyp) cholesterolosis: mucosal hyperplasia with the accumulation of cholesterol esters and triglycerides in the lamina propria macrophages (cf. intraluminal accumulation seen in adenomyomatosis) cholelithiasis papillomatosis 8 Exclusion [radiopaedia.org]
Diagnostic accuracy of transabdominal ultrasonography for gallbladder polyps: systematic review. Can J Surg. 2018 Jun; 61 (3):200-207. [ PMC free article : PMC5973908 ] [ PubMed : 29806818 ] 7. Shi XC, Tang SS, Zhao W. [ncbi.nlm.nih.gov]
Cancer, 69(11): 2647-52 [ PM ] [ EČ ][ GS ] Owen, C.C., Bilhartz, L.E. (2003) Gallbladder polyps, cholesterolosis, adenomyomatosis, and acute acalculous cholecystitis. [scindeks.ceon.rs]
Treatment
Adenomyomatosis is often asymptomatic and incidentally detected, requiring no specific treatment. Adenomyomatosis also can be associated with right upper quadrant pain. [ncbi.nlm.nih.gov]
It is most often an incidental finding and usually requires no treatment. It may be found more often in chronically inflamed gallbladders (which are at higher risk for carcinoma), but it is not a premalignant lesion in itself. [pacs.de]
It is most often an incidental finding and usually requires no treatment. It may be found more often in chronically inflamed gallbladders (which are at higher risk for carcinoma), but it is not a premalignant lesion in itself 6. [radiopaedia.org]
Prognosis
Prognosis Apart from the right upper quadrant abdominal pain that some patients experience, this is a benign condition and carries a good prognosis. Not all patients are symptomatic. [ncbi.nlm.nih.gov]
Nuclear medicine PET/CT Metabolic characterization with FDG PET has been suggested as a useful adjunct in problematic cases, but there have also been cases with increased uptake in areas of adenomyomatosis, leading to false positive results Treatment and prognosis [pacs.de]
[…] medicine PET-CT Metabolic characterization with FDG PET has been suggested as a useful adjunct in problematic cases 4, but there have also been cases with increased uptake in areas of adenomyomatosis, leading to false positive results 7 Treatment and prognosis [radiopaedia.org]
The main treatment method is surgical resection, patients can obtain a good prognosis after a simple complete excision of the lesion. [dovepress.com]
Etiology
The hypothesis of chronic inflammation as the etiology of adenomyomatosis is supported by the fact that patients are most frequently diagnosed in their 50s. [ncbi.nlm.nih.gov]
The etiology is unknown, although it has been associated with the use of oral contraceptives, anabolic steroids, certain storage diseases and some genetic mutations linked to maturity onset diabetes of the young. [reed.es]
Epidemiology
Epidemiology Adenomyomatosis is relatively common, found in ~9% of all cholecystectomy specimens. It is typically seen in patients in their 5 decade. The incidence increases with age, presumably the result of protracted inflammation (see below). [pacs.de]
Since patients are most frequently diagnosed in their 50s, the idea of chronic inflammation as the etiology seems plausible. [3] [4] Epidemiology Adenomyomatosis has been found in 1% to 8.7% of cholecystectomy specimens. [ncbi.nlm.nih.gov]
Pathophysiology
Pathophysiology [ edit ] Adenomyomatosis of the gallbladder as seen on ultrasound [2] Non-contrast abdominal ultrasound and contrast-enhanced ultrasound (CEUS) of adenomyomatosis of the gallbladder: [3] a The fundus of the gallbladder wall was thickened [en.wikipedia.org]
There is no known race predilection. [5] Pathophysiology Hyperplasia of the gallbladder wall is seen, with characteristic Rokitansky-Aschoff sinuses. Calculi and cholesterol crystals form within the sinuses. [ncbi.nlm.nih.gov]
Prevention
Cryotherapy may be chosen to preserve as much intact nipple tissue as possible for women of childbearing age who need to breastfeed.13 And it is necessary for patients to have regular breast follow-up with annual breast physical examination and mammography to prevent [dovepress.com]
The prevention of its complications is extremely important and treatment, which has recently evolved through the development of molecular subtypes, should be adapted to each case. [karger.com]