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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5302_Библиотеки_им_академика_М_И_Перельмана
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Adenoid Cystic Carcinoma
Definition: Slow-growing malignant tumor arising from glandular tissues,
often involving salivary glands.
Pathophysiology: Uncontrolled cell growth in glandular tissues, forming a
characteristic cribriform pattern.
Signs and Symptoms: Palpable mass, pain, cranial nerve involvement if
near the head and neck area.
Causes/Risk Factors: Unknown; genetic mutations may play a role.
Medical Management: Chemotherapy, radiation therapy.
Surgical Management: Wide local excision, sometimes involving nerve
resection.
Prognosis: Variable; tends to recur locally after excision.
Interesting Fact: Adenoid cystic carcinoma is known for its indolent
nature and prolonged clinical course, often requiring long-term
management.
Adrenal Adenoma
Definition: Adrenal adenoma is a benign tumor originating in the adrenal
glands.
Pathophysiology: Adrenal adenomas are usually non-functional, but some
can produce hormones, leading to various disorders (Cushing’s syndrome,
Conn’s syndrome).
Signs and Symptoms: Often asymptomatic. If functional, symptoms
depend on the hormones produced (e.g., hypertension in Conn’s
syndrome, weight gain in Cushing’s syndrome).
Causes/Risk Factors: The exact cause is unknown. Certain genetic
syndromes might predispose individuals to adrenal adenomas.
Medical Management: Observation for non-functional adenomas.
Functional adenomas may require medications to control hormone
production.
Surgical Management: Surgical removal (adrenalectomy) if the tumor is
functional, causing symptoms, or if there’s suspicion of malignancy.
Prognosis: The prognosis for benign adrenal adenomas is excellent after
surgical removal.
Interesting Fact: Many adrenal adenomas are discovered incidentally
during imaging for unrelated issues.
Adrenal Hemorrhage
Definition: Adrenal hemorrhage is bleeding into the adrenal glands, often
caused by trauma, surgery, or certain medical conditions.
Pathophysiology: Disruption of blood vessels in the adrenal glands,
leading to bleeding.
Signs and Symptoms: Abdominal or flank pain, low blood pressure, rapid
heartbeat, and dizziness.
Causes/Risk Factors: Trauma, surgery, sepsis, or underlying bleeding
disorders.
Medical Management: Stabilizing the patient, addressing the underlying
cause, and managing symptoms.
Surgical Management: Surgery might be necessary in severe cases to
control bleeding and remove damaged tissue.
Prognosis: Prognosis depends on the underlying cause and the extent of
adrenal damage. Timely intervention is crucial.
Interesting Fact: Adrenal hemorrhage can present as a medical emergency,
requiring swift diagnosis and intervention to prevent complications.
Adrenal Incidentaloma
Definition: Unintentionally discovered adrenal mass, often found during
imaging studies for unrelated issues.
Pathophysiology: Benign or malignant growth in the adrenal gland.
Signs and Symptoms: Often asymptomatic; may cause hormonal
imbalances if functional.
Causes/Risk Factors: Usually sporadic; some cases are related to genetic
syndromes.
Medical Management: Hormonal evaluation, imaging surveillance.
Surgical Management: Surgery for functional or suspicious masses.
Prognosis: Good for benign masses; variable for malignant tumors.
Interesting Fact: With advances in imaging technology, adrenal
incidentalomas are increasingly detected, posing challenges in
management decisions.
Adrenal Insufficiency (Addison’s Disease)
Definition: A condition where the adrenal glands do not produce enough
hormones, primarily cortisol and aldosterone.
Pathophysiology: Autoimmune destruction of adrenal glands, infections,
or certain medications.
Signs and Symptoms: Fatigue, weight loss, low blood pressure,
hyperpigmentation, salt cravings.
Causes/Risk Factors: Autoimmune disorders, infections (such as
tuberculosis), adrenal gland disorders.
Medical Management: Hormone replacement therapy (corticosteroids and
mineralocorticoids).
Surgical Management: Not applicable for primary adrenal insufficiency;
may be necessary if caused by adrenal tumors.
Prognosis: Good with lifelong hormone replacement therapy; requires
regular monitoring.
Interesting Fact: Addison’s disease can present with nonspecific
symptoms and often requires a high index of suspicion for diagnosis.
Adrenal Myelolipoma
Definition: Adrenal myelolipoma is a rare benign tumor composed of
mature fat cells and bone marrow elements in the adrenal gland.
Pathophysiology: Development of a non-cancerous tumor containing fat
and bone marrow tissue.
Signs and Symptoms: Often asymptomatic and discovered incidentally
during imaging tests. Large tumors can cause abdominal pain.
Causes/Risk Factors: Not well understood, often considered a random
occurrence.
Medical Management: Monitoring for growth, especially in asymptomatic
cases.
Surgical Management: Adrenalectomy if the tumor is large, causing
symptoms, or if it’s difficult to distinguish from malignancy.
Prognosis: Prognosis is excellent after surgical removal. Adrenal
myelolipomas are non-cancerous.
Interesting Fact: Adrenal myelolipomas are often found in imaging studies
and are considered rare incidental findings.
Ameloblastoma
Definition: Benign but locally aggressive tumor originating from the
odontogenic epithelium (in the jaw).
Pathophysiology: Uncontrolled cell growth in the jawbone.
Signs and Symptoms: Jaw swelling, pain, difficulty in chewing.
Causes/Risk Factors: Unknown; usually sporadic.
Medical Management: None; surgical intervention for removal.
Surgical Management: En bloc resection, sometimes involving
reconstruction.
Prognosis: Good; recurrence is possible after incomplete excision.
Interesting Fact: Ameloblastomas are more common in the lower jaw and
require complete surgical removal due to their locally aggressive nature.
Ampullary Cancer
Definition: Malignant tumor originating from the ampulla of Vater, where
the common bile duct and pancreatic duct meet and enter the duodenum.
Pathophysiology: Uncontrolled cell growth in the ampullary region.
Signs and Symptoms: Jaundice, abdominal pain, weight loss, changes in
stool color.
Causes/Risk Factors: Unknown; may be related to chronic inflammation
or genetic factors.
Medical Management: Chemotherapy, radiation therapy.
Surgical Management: Whipple procedure (pancreaticoduodenectomy).
Prognosis: Generally better than other pancreatic cancers due to earlier
symptoms and detection.
Interesting Fact: Ampullary cancer is a rare subtype of pancreatic cancer
and often has a better prognosis than tumors originating from other parts
of the pancreas.
Anal Abscess and Fistula
Definition: Collection of pus near the anus (abscess) or abnormal tunnel
between the anus and skin surface (fistula).
Pathophysiology: Infection of anal glands leads to abscess formation; if
not properly drained, it can result in a fistula.
Signs and Symptoms: Pain, swelling, redness, discharge, fever.
Causes/Risk Factors: Infection of anal glands.
Medical Management: Incision and drainage for abscess. Surgical
intervention for fistula.
Surgical Management: Fistulotomy (opening and draining the fistula tract)
or other specialized procedures.
Prognosis: Generally good with proper drainage and surgical
management.
Interesting Fact: Anal fistulas often result from untreated or inadequately
treated anal abscesses.
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