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Adenoma — Clinical Guidelines

Overview

Adenomas are benign epithelial tumors that can occur in various organs, including the colon, prostate, and rarely in other locations such as the nipple or ileal urinary conduit. They are often precursors to malignant transformation, particularly in colorectal adenomas.

Diagnosis

Colorectal Adenomas: Detected via colonoscopy with biopsy confirmation 2 3.

Fecal Immunochemical Test (FIT): Used for screening, with AI models enhancing diagnostic accuracy 2.

Microbial Markers: Fecal microbial signatures may complement FIT for advanced adenomas 3.

Imaging: CT scans useful for assessing local extension and complications (e.g., perirectal fascia thickening post-prostatic resection) 7.

Cytology: Fine needle aspiration can diagnose rare cases like adenoma of the nipple 9.

Management

Colorectal Adenomas: Polypectomy or endoscopic resection for removal 2.

Prostatic Adenomas: Transurethral resection (TURP) or cryosurgery for symptom relief 15.

Adjunctive Treatments: No specific drug dosing mentioned; focus on symptom management and monitoring for progression 15.

Special Populations

Elderly: Management considerations include risks associated with surgical interventions; cryosurgery may be preferred for high-risk patients 15.

Comorbidities: Ureteral stasis in patients with cervicoprostatic obstructions managed primarily through addressing obstructing masses rather than direct ureteral compression 12.

Key Recommendations

Utilize AI models alongside FIT for improved diagnostic accuracy in colorectal adenoma screening (Evidence: Moderate) 2.

Employ colonoscopy with biopsy for definitive diagnosis of colorectal adenomas (Evidence: Strong) 2.

Consider cryosurgery as a viable option for high-risk patients with prostatic adenomas, acknowledging it as a palliative measure (Evidence: Expert opinion) 15.

References

1 Fan C, Cai J. A Case of Solitary Pulmonary Papillary Adenoma. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2025. link 2 Eskelinen M, Selander T, Guimarães DP, Kaarniranta K, Syrjänen K, Eskelinen M. Artificial Intelligence Models Could Enhance the Diagnostic Accuracy (DA) of Fecal Immunochemical Test (FIT) in the Detection of Colorectal Adenoma in a Screening Setting. Anticancer research 2025. link 3 Zhang Y, Lu M, Lu B, Liu C, Ma Y, Liu L et al.. Leveraging Fecal Microbial Markers to Improve the Diagnostic Accuracy of the Fecal Immunochemical Test for Advanced Colorectal Adenoma. Clinical and translational gastroenterology 2021. link 4 János G, Marosán M, Kozma A, Mándoki M. Solitary adenoma in the proventriculus of a budgerigar (Melopsittacus undulatus) diagnosed by immunochemistry - short communication. Acta veterinaria Hungarica 2011. link 5 La Marca F, Orlando G, Jallous H, Remotti M, Marandola P. Case report: uneventful treatment of a giant prostate. Archivos espanoles de urologia 1995. link 6 Raju GC, Roopnarinesingh A, Woo J. Villous adenoma of female urethra. Urology 1987. link90523-1) 7 Parienty RA, Vallancien G, Pradel J, Veillon B. CT features of perirectal fascia thickening after transurethral resection of prostatic adenoma. Journal of computer assisted tomography 1987. link 8 Calabró A, Di Prima F, Aragona F, Garbeglio A. Bladder herniation through abdominal wall: an exceptional complication of retropubic prostatic adenomectomy. Urologic radiology 1987. link 9 Stormby N, Bondeson L. Adenoma of the nipple. An unusual diagnosis in aspiration cytology. Acta cytologica 1984. link 10 Peterson NE. Adenoma of ileal urinary conduit. The Journal of urology 1984. link50859-9) 11 Min KW, Gyorkey F. Prostatic adenoma of ductal origin. Urology 1980. link90346-5) 12 Thiry AJ, Gregoir W. Ureteral stasis in cervicoprostatic obstructions. European urology 1980. link 13 Jurgeleit HC. Villous adenoma of the colon with severe fluid and electrolyte depletion: report of a case. Diseases of the colon and rectum 1976. link 14 Horvath E, Kovacs K. Mitochondrial derivation of centrioles in some endocrine adenomas. Experientia 1976. link 15 Haschek H. Cryosurgery of prostate adenoma: evaluation of the method. Progress in clinical and biological research 1976. link 16 Fevre DI. Villous adenoma of the colon with electrolyte depletion. The Medical journal of Australia 1975. link 17 Gaszyński W, Lisicki J, Zalewski A. Studies of blood clotting system during anaesthesia for prostatectomy. I. Epidural analgesia. Anaesthesia, resuscitation, and intensive therapy 1975. link

Adenoma