What is an adenoma?

An adenoma is a benign growth that can, however, develop into cancer. The term "adenoma" comes from the ancient Greek word "gland" (aden) and the part of the word -ma, which means "tumour" or "effusion". Accordingly, an adenoma also arises from the uppermost cell layer of glandular tissue (benign epithelial neoplasia), for example of the thyroid gland, but can in principle affect any organ. Most often, however, an adenoma forms from the mucous membrane of the gastrointestinal tract and appears, for example, in the form of polyps. If several adenomas occur, doctors call it adenomatosis.

What forms of adenomas are there and what symptoms can they cause?

Doctors distinguish between the following adenomas, which can also cause different symptoms depending on where they develop:

• Adenoma of the gastrointestinal tract: appears as an internal bulge in the intestine. Adenoma of the gastrointestinal tract can become a malignant tumour.
• Symptom: blood in the stool.

• Adenoma of the tonsils: this mainly affects the adenoids, also called polyps.
• Symptoms: Difficulty breathing; increased susceptibility to infections in the throat, nose, ear area
• Pituitary adenoma: benign tumour that develops from the tissue of the adenohypophysis and is relatively common in the form of prolactinoma. A pituitary adenoma can lead to excess secretion of one or more hormones of the anterior pituitary lobe.
• Symptoms: depend on which hormones are secreted excessively. In women, for example, a prolactinoma can cause menstrual irregularities, sterility, breast growth and/or milk flow. In men, a prolactinoma is often noticeable through sexual disinterest and rather rarely through breast enlargement and/or breast pain.

• Renal adenoma: this is the general term for benign epithelial neoplasms of the kidney that produce hormones. They are distinguished from malignant renal cell carcinoma.
• Symptoms: can manifest themselves in different forms depending on the hormone production

• Thyroid adenoma: belongs to the most common tumour of the thyroid gland and affects women on average more often than men. Thyroid adenoma is a neoplasm of the follicular epithelium in which excess hormones may be produced.
• Symptoms: Palpitations, tremors; sweating, unwanted weight loss, food cravings

• Adenoma of the prostate (also called benign prostatic hyperplasia BPH): often occurs in men over the age of 50. The prostate adenoma causes the prostate to enlarge and compresses the urethra.
• Symptoms: frequent urge to urinate; delayed urination; residual urine sensation

• Adenoma of the ovaries: depending on the size, the adenoma is removed by laparoscopy or surgical removal of the affected ovary. As a rule, the fallopian tube is also removed from the age of 40 and, after the menopause, the uterus as well as the ovaries and both fallopian tubes.
• Symptoms: only appear when the adenoma of the ovaries displaces other organs due to its size and can manifest itself in the form of a feeling of fullness, a defecation disorder of the bowels and bladder as well as lower back or abdominal pain. If the adenoma produces hormones, bleeding may also occur outside of menstruation.

• Hepatocellular adenoma: can occur in women due to long-term use of oral contraceptives if there is a genetic predisposition to it. A hepatocellular adenoma is surrounded by an outer capsule, develops singly or in groups, usually in the right lobe of the liver, and can grow to several centimetres in size.
• Symptoms: severe abdominal pain due to necrosis or haemorrhage of the adenoma; one-tenth of the haemorrhages can be life-threatening

• Nipple adenoma: is a benign tumour that occurs in the area of the nipple (mammilla ). A nipple adenoma is usually macroscopically bulging.
• Symptoms: reacts painfully to pressure and tends to bleed easily when touched.

• Fibroadenoma: is the most common type of benign breast tumour, which occurs mainly between the ages of 20 and 40 and almost never degenerates.
• Symptoms: A fibroadenoma can be felt in the breast as a lump, can be moved and is easily distinguished from the surrounding breast tissue.

How is an adenoma diagnosed?

Depending on the type of disease, an adenoma can be diagnosed during a routine or early diagnostic examination. This includes, for example, adenoma of the gastrointestinal tract, which is detected by a colonoscopy and subsequent microscopic examination. The diagnosis of a fibroadenoma, on the other hand, is made by an ultrasound examination (sonography) or a puncture.

If an adenoma also produces hormones, like the pituitary adenoma, these can be detected by a blood test and the tumour can then be searched for by means of a computer tomography (CT) or a magnetic resonance imaging (MRI). If there is a suspicion that the tumour is producing growth hormones, a provocation test must also be carried out (glucose load test).

How is an adenoma treated?

Depending on the form of the adenoma and the symptoms it causes, surgery may be used if necessary. This is the case, for example, with kidney adenomas or pharyngeal tonsils that appear in early childhood. It is possible to remove pharyngeal tonsils by adenotomy or surgically using a laser or a scraping knife. A thyroid adenoma is also usually removed surgically or destroyed by radioiodine therapy.

In any case, the treatment of an adenoma always aims at the complete removal of the tumour. In the case of growth hormone-producing tumours, this can also be done with medication. It is also possible to take medication to reduce the size of the tumour before surgery if the adenoma is still too large or if it is difficult to separate it from the neighbouring tissue. If neither surgery nor drug therapy is possible, radiotherapy can also be considered.