Adrenal tumors can grow from the medulla or cortical layer. They are malignant or benign, differ in morphological and histological structure, clinical signs, etc.
The rarely occurring adrenal tumor is androsteroma, it accounts for only 1-3% of the total number of tumors.
What is androsteroma?
Androsteromas are called hormonally active, verifying tumors that produce androgenic hormonal substances.
Similar formations proceed mainly from the reticular zone of the adrenal cortex.
The clinical picture of such formations is largely similar to congenital adrenal dysfunction. Androsteromas can grow to considerable sizes, reaching 1-1.2 kg.
Androsteromas are found mainly in young women under 40 years of age, in men, such tumors are detected with a slightly lower frequency.
Such a difference is explained by specialists due to diagnostic difficulties, because virilization is less pronounced in mature men, therefore some of these formations take place under the cover of hormonally inactive adrenal tumors.
The remaining patients are diagnosed with a benign androdermal form - the androgen-producing adrenal adrenal cortex, which usually has the appearance of a light, rounded, single formation of 5-6 cm in size.
Causes of tumor
The appearance of androsteroma and its further growth is caused by excessive production of androgenic hormones. But the exact cause of such an anomaly is unknown.
Excessive production of hormones causes female virilization and premature child sexual development. Benign Androsteromas on the cut look like a reticular area of the adrenal cortex.
Androstier malignant formations are characterized by a multitude of foci of necrosis and the presence of atypical cellular structures. And with malignant androsteromas, metastasis is often observed in pulmonary, hepatic tissues or retroperitoneal space.
Specialists are inclined to believe that such factors as:
- Abuse of oral contraceptives may also provoke the development of androsteroma;
- Hereditary weight;
- Ovarian polycystic;Excessive content of bad cholesterol;
- Diabetes;
- Hypokalaemia;
- Tobacco smoking;
- Bilateral hyperplastic changes of the adrenal cortex, etc.
The criterion by which the nature of the tumor can be assumed is the size.
Large androsteromas more than 5 cm in diameter are usually malignant in nature and actively metastasize to retroperitoneal lymph nodes, the liver and lung structures. Particularly characteristic are malignant androsteromas for children of childhood.
Symptoms of the disease
Because the basis for the mechanism of development of androsteroma is the excessive secretion of androgens, ie, the sex hormones of men. Therefore, the main manifestation of such tumors is virilization or digestion.
- Girls start early puberty, pubic hair and body hair appear in accordance with the male type, the voice becomes rough, the muscles grow and the clitoris grows. In this case, girls do not have menstruation and there is no growth of mammary glands.
- The boys also have premature ripening - there is active hair on the armpits and pubis, with small testicles the penis begins to increase, muscles are actively forming, the timbre of the voice coarsens.
- Children with androsteroma grow rapidly, however, they have premature closure of bone growth zones, therefore, they are typically stunted. But active development in children with similar formations is only secondary signs, and the formation of ovaries and testes is in accordance with age.
Women with androsteromas note that they are worried:
- Active growth of hair on the whole body, face( antennae, beard, etc.), breasts;
- On the head, on the contrary, there are bald spots;
- Ladies complain about problems with menstruation, which are characterized by amenorrhea or oligomenorrhea;
- As a result of atrophic processes, breast reduction occurs;
- There is a serious disruption of the proportions between muscle tissues and fatty tissue;
- The clitoris increases, its pronounced virilization takes place.
In men, the signs of virilization are not so pronounced, so the androsteromas in them are usually detected by accidental examination for another reason. General health at the initial stages of the tumor process usually does not change.
Initially, women experience a surge of energy and increased efficiency, increased libido, etc. But soon this energy charge goes through and comes a state of depression, constant fatigue, lability, weakness and exhaustion.
When androsteroma grows to large sizes, there is a pain symptomatology caused by squeezing the nearest nerve endings.
Diagnosis
Adrenal tumor is considered a serious enough pathology, since even benign androsteroma can be re-qualified as a malignant variant.
Therefore, diagnostics require the most qualified approach.
Patients undergo diagnostic procedures such as:
- Laboratory blood tests for sugar, cholesterol and hormones;
- Ultrasonography of the adrenal gland;
- Magnetic resonance and computed tomography;
- Puncture tissue research, etc.
Treatment and prognosis with adrenal androde
Treatment of adrenal androster only operative. Since most of these tumors are of a malignant nature, early diagnostics at the initial stage can save a patient's life.
Therapeutic measures involve the removal of the adrenal gland, affected by the tumor process.
If androsteroma is of a malignant nature and is found at late stages of pathology, when there are numerous metastases, the treatment is symptomatic and involves the use of pain medications, radiation and chemotherapy.
With the timely detection of benign tumors, the prognosis is favorable. With malignant nature of education, forecasts are favorable only for early detection and timely qualified surgery. If the delay is detected, the forecasts are unfavorable.