What is Adenoma?

Adenomas are benign tumors of the glandular epithelium. Found in breast, pituitary, thyroid, ovary and other endocrine glands and stomach, intestine, liver and other places. It develops slowly and forms localized nodules with a polypoid or papillary surface. Biopsy is feasible, and it is not difficult to get a diagnosis based on clinical manifestations and related examinations.

Basic Information

English name

adenoma

Visiting department

Department of Pathology

Common causes

Cystic adenoma, fibroadenomas, pleomorphic adenomas, polypoid adenomas

Common symptoms

Thyroid adenoma, breast fibroadenomas, masses, lymph nodes

Cause of adenoma

Cystadenoma

Due to the accumulation of glandular secretions in adenoma tissue, the glandular cavities gradually expand and fuse with each other into cysts of varying sizes, hence the name. It is mainly found in the ovary and occasionally in the thyroid and pancreas. There are two types of ovarian cystadenomas: one is myxoid cystadenomas, which are often multilocular, with smooth cystic walls and few papillary hyperplasia. The other is serous papillary cystadenoma. The glandular epithelium is papillary hyperplasia into the cystic cavity and secretes serous fluid, so it is called serous papillary cystadenoma.

2. Fibroadenomas

It is the most common benign tumor of the female breast. In addition to glandular epithelial cell proliferation, it is also accompanied by fibrous connective tissue hyperplasia. This tumor is a common benign tumor in women.

3. Polymorphic adenoma

Occurs in salivary glands, especially the parotid gland, which was often referred to as mixed tumors. It is composed of glandular tissue, mucus-like tissue and cartilage-like tissue. The tumor grows slowly, but often relapses after resection.

4. Polypoid adenoma

Occurs in the mucosa, which is polypoid, with pedicles connected to the mucosa, and is more common in the rectum. Among them, papillary or villous polypoid adenomas with higher malignant rates. Colonic multiple adenocarcinoma polyposis often has a family inheritance, which not only has a high rate of canceration, but also is prone to early canceration.

Adenoma clinical manifestations

Thyroid adenoma

Patients are mostly women, often under 40 years of age, and are usually single nodules in the thyroid. The course of the disease is slow, most of which are months to years or even longer, and the patient is found to have a neck mass due to slight discomfort or no symptoms. Most of them are single, round or oval, with smooth surface, clear borders, firm texture, no adhesion to surrounding tissues, no tenderness, and can move up and down with swallowing. A small number of patients due to intratumoral hemorrhage will suddenly enlarge the tumor with pain; some lumps will gradually absorb and shrink; some may occur cystic changes.

2. Breast fibroadenoma

(1) Most of the lumps are unintentionally found in the breast. Two-thirds of the lumps are 1 to 3 cm in size, and more than 10 cm in individual cases. The parts are mostly above the breast, mostly single, and a few are multiple, round or oval, with clear borders, smooth surface, toughness, good activity, and no adhesion to the epidermis and pectoral muscles.

(2) Most of the pain is painless mass, only 14% have mild pain, which is paroxysmal, occasional or triggered during menstruation.

(3) There is clear discharge from nipples , but it is rare, accounting for about 0.75%.

(4) Lymph nodes Axillary lymph nodes are not enlarged.

Adenoma test

Thyroid adenoma

(1) B-ultrasound can further confirm whether the mass is solid or cystic, whether the edges are clear, the mass is mostly single or multiple, and it is 2 to 3 small masses, and the ipsilateral glandular lobe is correspondingly enlarged. , Solid for adenoma. Cystic is a thyroid cyst.

(2) Isotopic scan ¹³¹ I scan showed that the thyroid was a warm nodule, and the cystadenoma could be a cold nodule. Most thyroid nuclide scans are warm nodules, but they can also be hot or cold.

(3) If the tumor is large on the neck X-ray film , the trachea is compressed or displaced in the front and lateral radiographs, and some tumors can be seen with calcified images.

(4) Thyroid lymphography showed a circular filling defect in the reticular structure, regular edges, and complete visualization of surrounding lymph nodes.

2. Breast fibroadenoma

(1) X-ray molybdenum target radiographs have clear and smooth edges, and the masses are uniform.

(2) The biopsy fibroid has an envelope outside, which is hard in quality, and has a gray-white cut surface, which is bright, and many irregularly arranged cracks are visible to the naked eye.

Adenoma diagnosis

It is not difficult to draw a diagnosis based on clinical manifestations and related examinations.

Adenoma treatment

Thyroid adenoma

Thyroid lobectomy is a more thorough surgical method. If the frozen section is confirmed to be differentiated thyroid cancer during surgery, as long as there is no enlarged lymph nodes in the neck, regular follow-up can be performed. Adenomas that are clinically considered to be single but actually multiple can also be completely removed to avoid reoperation.

2. Breast fibroadenoma

The most effective treatment for breast fibroids is surgery. Although breast fibroadenoma is benign, it may be malignant, so once it is found, it should be surgically removed. Surgery can be performed under local anesthesia. After the tumor was revealed, it was removed in one piece with its capsule. The resected mass must be routinely examined for pathology to exclude the possibility of malignant lesions.