Left adrenal adenoma is a fairly common disease that occurs in women in 70% of cases. A disease manifests itself in the formation of a benign glandular tumor.
What are the causes of its occurrence? What are the prerequisites? What symptoms may indicate its presence, as well as what is needed for treatment? Well, this and much more will now be discussed.
Briefly about the disease
The adrenal glands are paired endocrine glands, which play a crucial role in the regulation of metabolism, as well as in the adaptation of the body to negative conditions (to stress, to be more precise).
Anatomically, they are located on the upper pole of the kidneys, and consist of two layers - cortical and cerebral. In each of them hormones are synthesized. Adrenaline is produced in the brain. In the cortical - androgens, glucocorticoids and mineralocorticoids.
Hormones are responsible for the regulation of diastolic and systolic pressure, for the water-salt balance and metabolism. Androgens are involved in the development of secondary genital organs. Adrenaline is known to be a stress hormone.
What is an adenoma of the left adrenal gland? This is a benign neoplasm of a homogeneous structure derived from glandular tissue, capable of producing hormones. Unfortunately, because of this property, it is capable of causing severe disturbances in the body.
Classification
The hormone-producing adenoma of the left adrenal gland is divided into the following types:
- Corticosteroma. It synthesizes glucocorticoids.
- Corticoestroma. Such a tumor produces estrogens.
- Androsteroma. Synthesizes androgens.
- Aldosteroma. It forms mineral corticoids.
- Combined. Adenoma of this type produces several hormones at once.
By structure, a tumor can be of the following types:
- Nodular, adrenocortical. It has a light color, is in a capsule with liquid. It is common, has a very high risk of degenerating into a malignant neoplasm.
- Pigmented. It is also a capsule with liquid, but a dark red hue. It is diagnosed in approximately 10% of patients. At risk are patients with Itsenko-Cushing's disease.
- Oncocytic. It consists of cells, has a "grain" structure. Very rare pathology. If such a tumor has formed, then it is likely that it will grow rapidly and cover the entire organ.
Also, left adrenal adenomas are classified by size. There are four such species:
- Picoadenoma. 3 mm.
- Microadenoma. Maximum 10 mm.
- Macroadenoma. More than 10, but less than 40 mm.
- Giant tumor. Size exceeds 40 mm.
It is important to make a reservation that any adenoma more than 30 mm is considered malignant. More tumors are divided into dark cell, clear cell and mixed.
Causes
Why exactly an adenoma is formed is still not known exactly. The causes of the formation of tumors are not fully understood. It is believed that people at risk include smokers. But this is only an assumption. What could be proved - so this is a fact of the development of tumors as a result of increased load exerted on the glandular tissue. The prerequisites include the following factors:
- Heart attacks and strokes.
- Hereditary predisposition.
- Pathologies of somatic, endocrine nature.
- Hypertension.
- Bilateral hyperplasia of the adrenal cortex.
- Tumors and cysts formed in other organs.
- Operations or injuries affecting the adrenal glands or nearby organs.
There are some other conditions that should be noted attention. They are not a direct cause of the development of adenoma, but are quite capable of exerting a decisive influence on the start of the pathological process. You can define them in the following list:
- Regular stress and anxiety, psycho-emotional stress.
- Obesity.
- Type 2 diabetes mellitus.
- Dyslipidemia.
- Chronically elevated blood pressure.
- Weakened immunity.
- Hyperproduction of hormones.
- The use of oral contraceptives is not in accordance with the instructions.
Symptoms
The formation of an adenoma of the left adrenal gland proceeds at first without any manifestations. A tumor is very difficult to detect, especially at an early stage. Plus, if any symptoms appear, most of them are similar to manifestations of other ailments. And the most common symptom is chronically elevated blood pressure, which cannot be brought down by any medication.
If the tumor forms at an early age, then it can be recognized by external changes. The child's figure and voice are transformed, and hair growth appears. Be that as it may, the active changes depend on which hormone the tumor produces.
With corticosteroma, for example, which is a common neoplasm, the following symptoms are common:
- Impaired breathing.
- Unreasonable obesity.
- Swelling, bruising, sprain.
- Active sweating.
- Pain when walking.
- Increased bone fragility.
- The development of osteoporosis and hernia.
- Depression, mood swings.
- Infertility.
- Disturbed menstruation in women.
If, for example, left adrenal adenoma (ICD-10 D35.0) produces male hormones, then in women this is manifested by the following symptoms:
- Muscle development.
- Male type hair.
- Change of voice (it becomes rude).
- Breast reduction
- Menstrual irregularities.
In men, androsterone does not manifest itself in any way. But a tumor of another species can provoke the onset of general feminization.
Specific signs are present in aldosteromas. It provokes an increase in blood volume, the appearance of muscle spasms, increased blood pressure, impaired heart function, as well as sodium and fluid retention in the body.
Diagnostics
As a rule, adenoma of the left adrenal gland in women and men is detected during a routine medical examination. After its discovery, laboratory diagnostics must be prescribed. Its purpose is to determine whether the adenoma is hormone-producing or not.
It is also necessary to donate blood so that specialists analyze the level of cortisol and aldosterone in it.
Instrumental diagnostics of adenomas of the right and left adrenal glands is prescribed in order to identify the exact location of the neoplasm, its size, as well as the prevalence.
If the endocrinologist considers it appropriate, then he can prescribe the passage of such events:
- CT scan.
- MRI
- Ultrasound of the abdominal cavity.
- An analysis to study hormonal imbalances.
- Tumor biopsy.
- Blood glucose test.
Some points need to be clarified. Since the adrenal gland is deep in the retroperitoneal space, ultrasound may not always give the necessary amount of information. Therefore, MRI and CT are preferable. Computed tomography is often complemented by contrasting. But the best results can be achieved by performing research on a multispiral tomograph. This device allows you to get more sections of the tumor.
A biopsy is quite difficult. Again, due to localization. And the trauma of this procedure is not very justified. The diagnostic value, in turn, is also small. However, a biopsy cannot be dispensed with if the doctor suggests that the organ is affected by cancer metastasis.
It is very important in the process of examination to differentiate the adenoma of the medial leg of the left adrenal gland from another neoplasm. Namely, from the pituitary microadenoma. The symptomatology is similar, and the origin too - this is the name of the neoplasm, no larger than 1 cm in size, which is formed from glandular tissue.
Complications
It is impossible not to tell about the consequences of adenoma of the left adrenal gland. If a person starts a tumor, then soon he will face complications. After all, hormones produced by the adrenal gland normalize the work of the most important body systems. Any violations lead to sad consequences. Among them:
- Obesity. It leads to a violation of the synthesis of cortisol. This effect usually affects women aged 20 to 40 years. And obesity is observed in 90% of patients. As a rule, it is localized in nature - it is deposited on the face, stomach, chest. On "obese" places you can notice a thinned skin and even partial atrophy of the muscle apparatus. The result may be hemorrhage in the subcutaneous layer and purple striae.
- Osteoporosis. Lack of cortisol leads to it. If the body does not have enough of this hormone, then the structure of the bone tissue will weaken (the reason is the constant loss of mineral elements). This is fraught with a decrease in the height of the spinal column and compression type fractures.
- Problems with the nervous system. Anything can arise - from lethargy to psychotic reactions and depression. Lack of cortisol and aldosterone also leads to this. It is because of this that impulses along nerve fibers are transmitted incorrectly.
- Diabetes. It occurs due to a violation of the production of the hormone, which is responsible for the synthesis of insulin.
- Muscle weakness and cramps. This effect is caused by a decrease in the amount of potassium in the bloodstream.
And, of course, there is always a risk of degeneration of the adenoma into a malignant neoplasm. Because any tumor can lead to cancer. And in this case, the forecast will be unpredictable.
Laparoscopy
Now we should talk about the treatment of left adrenal adenoma. If the tumor is small, then the doctor may prescribe laparoscopy. It is very important that there are no metastases.
Laparoscopy is performed as follows: on the tissues of the middle and upper part of the peritoneum, several small incisions are made, the length of which does not exceed 5-12 mm. Through them, the surgeon introduces a special optical device - it is with his help that he will monitor the removal process.
After the operation, the patient will be in the hospital for another 3-5 days. Rehabilitation does not take much time - patients recover quickly, since the method of conducting the intervention is endoscopic.
Classic delete
If a person is diagnosed with, say, an adenoma on the left adrenal gland with a hydronephrotic sac, then laparoscopy will not help him. In severe cases, classic tumor removal is indicated.
By performing a resection, you can effectively get rid of the pathology. But you will need to make a strip section of the abdominal wall. This is a traumatic operation, since the area affected is not small. And rehabilitation, of course, takes much longer.
It should be noted that even the volumetric formation (adenoma) of the left adrenal gland is easier to remove than a smaller tumor on the right side. All due to anatomical features. Access to the left adrenal gland is less difficult than to the right. Accordingly, it is easier to treat.
The nuances of therapy
Continuing to talk about the treatment of left adrenal gland adenoma, it should be noted that there are such cases when a biopsy reveals the malignant nature of the tumor. In this case, the patient is prescribed a radio wave and a chemical effect on the adenoma. The use of specific drugs will help to prevent the rapid growth of atypical cells.
In malignant adenoma of the left adrenal gland, the drugs indicated for use are adrenostatics.
If the removal of the tumor is not possible, resort to drug therapy. A well-known drug is Metirapon, an agent that suppresses the terminal stage of cortisol synthesis. Ketoconazole, a synthetic drug that has fungistatic and fungicidal effects, is also often prescribed.
Folk remedies
Specialists are skeptical of alternative medicine. But some believe that at the initial stage of tumor development, they can be resorted to. Well, as an adjunctive therapy, this may be appropriate. You can stop unpleasant symptoms by making healing products according to the following recipes:
- Pour a glass of boiling water geranium (30 g). Let it brew for 15-20 minutes. Then drink like tea.
- Take dried snowdrop flowers (80 g) and add alcohol (500 ml). Send for 40 days to a warm place. Then strain and drink 20 drops twice a day before meals. It is recommended to breed in a small amount of water.
- Mulberry leaves (50 g) pour boiling water (600 ml). Send to low heat for 20 minutes. After the time has passed, turn it off and let it brew for 15 minutes. Then strain. Drink during the day instead of tea.
- Pour boletus (30 g) with hot water (1 l). Insist for 30 minutes. Then take 200 ml 4 times a day.
Before using this or that folk remedy, you must always consult your doctor.
How to live with one adrenal gland?
If the tumor has become malignant and affected the organ, then it will most likely have to be removed completely. According to the reviews left about the operation of the adenoma of the left adrenal gland, the consequences that arise depend on the individual characteristics of the body, as well as on the method of intervention.
Of course, for some time the patient experiences discomfort. He manages to "drown out" the use of drugs prescribed by the doctor. Rehabilitation takes at least a few weeks. A person will have to visit a doctor often, as well as register, so that after recovery regularly undergo examinations. They are necessary to convince that no new tumors have appeared, and the patient is healthy.
Complications are possible after surgery. Among them:
- Severe shortness of breath.
- Joining an infection.
- Damage to adjacent tissues.
- Stroke.
- The rejection of drugs by the body.
- Postoperative hernia.
- Hormonal problems.
However, all this happens extremely rarely, since in our time medicine is quite developed, and therefore the methods of surgery used are modern and almost safe.
But the hormonal balance of the operated person needs to be given special attention. The patient will have to undergo a rehabilitation course aimed at restoring his background. If you follow a healthy lifestyle and the diet shown by the doctor, there will be no problems - the second adrenal gland will completely perform the function of both, and for this you will not even need to take specific medicines.