ASRAT WOLDYES HEALTH SCIENCE CAMPUS

SCHOOL OF NURSING AND MIDWIFERY

DEPARTMENT OF SURGICAL NURSING
SURGICAL NURSING 3
grouP assignment
 PrePared by
4th yr surgical nursing students
Name sex ID
Mohammed Jemal M 1401906

Nebay Yilkal M 1402138

Nardos Siyum F 1402041

Sumeya Husen F 1402412

Fikremaryam Arega M 1402743

Submitted To Instructor Bethelehem T.

date 28/04/2025
 a
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 Defination
 types of adenoma
 risk factors
 Pathophysiology
 sign and symptoms
 treatment modalities
 summary
 Defination
An adenoma is a benign
(noncancerous) [Link] start in
epithelial tissue, the tissue that covers
your organs and glands.

These tumors grow slowly and look like

small mushrooms with stalks
 cont...
Adenomas most commonly grow
along your glandular organs.

Glandular organs produce and

release chemicals called hormones.
Hormones regulate many of your
body’s functions.
 cont....
 It can occur in various organs and there
are many types of adenomas, including:
Adrenal adenomas:
Colon adenomas (a type of colon polyp)
Parathyroid adenomas:
Pituitary adenomas:
Pleomorphic adenomas:
Sebaceous adenomas:
 cont....
 Based on how they grow healthcare providers categorize
adenomas . An adenoma can be:
 Tubular: Grows in a round or oval shape and is most common
in small adenomas measuring less than 0.5 inches (1.27
centimeters).
 Villous: Grows in a shaggy, cauliflower-like pattern and is most
common in larger adenomas.
 Tubulovillous: A mixture of tubular and villous growth patterns.
 Sessile: Grows in a flattened shape and has a larger base
(instead of a stalk-like base).
 Serrated: Has a saw-tooth pattern under a microscope.
 Sessile serrated: A mixture of sessile and serrated growth
patterns.
 cont...
 In the Integumentary System:
 Adenomas can form in structures such as
sebaceous glands or sweat glands, although
they are relatively rare.
 Sebaceous Adenoma
 A sebaceous adenoma is a benign tumor of the
sebaceous glands, which are oil-producing
glands in the skin.
 It typically appears as a small, yellowish or skin-
colored bump, often on the face, scalp, or neck.
 Though usually harmless, sebaceous adenomas
can sometimes be a marker for an underlying
genetic condition, especially Muir-Torre
syndrome, which is linked to internal cancers .
 cont....
The Cause of Sebaceous Adenoma unknown
but some assemtion are
Overgrowth of sebaceous gland cells due to
unknown triggers.
Inherited mutations in DNA mismatch repair
genes (e.g., MSH2, MLH1) in syndromic
cases.
Sporadic (non-inherited) cases occur without
clear cause.
 Risk Factors
 Age – Most common in middle-aged and older adults.

 Genetic conditions – Especially Muir-Torre syndrome (a

subtype of Lynch syndrome).

 Family history of sebaceous tumors or internal

malignancies.

 Immunosuppression – May increase skin tumor risk.

 Chronic sun exposure – Can play a role in skin tumor

development.
 Pathophysiology

 Sebaceous glands are part of the pilosebaceous unit

(hair follicle + sebaceous gland).
 In sebaceous adenoma, there is a benign proliferation of
sebocytes (sebaceous cells) arranged in lobules.
 The growth is well-differentiated (cells resemble normal
sebaceous cells) and usually encapsulated, meaning it
doesn't invade nearby tissue.
 In Muir-Torre syndrome, loss of mismatch repair (MMR)
proteins leads to uncontrolled cell growth and tumor
formation, including sebaceous tumors.
 Signs and Symptoms
 Most common locations: face, scalp, neck, and upper
trunk.
 Painless, slow-growing nodule.
 Typically yellow, skin-colored, or pink.
 Usually less than 1 cm in size.
 Surface may be smooth or lobulated.
 Typically asymptomatic (no pain, itching, or bleeding).
 Multiple lesions may raise suspicion for a genetic
syndrome.
cont...
 Diagnosis
 Clinical examination – Dermatologist assesses size,
shape, and location.
 Skin biopsy – Confirms the diagnosis by examining
tissue under a microscope.
 Immunohistochemistry – Used to evaluate MMR protein
expression (in cases suspected for Muir-Torre
syndrome).
 Genetic testing – May be indicated if Muir-Torre is
suspected.
 Treatment:
 Surgical Excision; Simple removal of the lesion and Often
curative with minimal risk of recurrence.
 Cryotherapy or Electrosurgery; For superficial or small lesions.
 Laser Treatment; Can be used for cosmetic removal.
 Monitoring; Small, asymptomatic lesions may be observed.
 Genetic Counseling and Surveillance; If associated with a
hereditary syndrome like Muir-Torre, further screening for
internal cancers is necessary.
 Eccrine Poroma
 Eccrine poroma is a benign tumor that arises
from the intraepidermal portion of the eccrine
sweat gland duct.
 These tumors are most commonly found on
areas rich in sweat glands, particularly the
soles of the feet and palms of the hands, but
can occur anywhere.
 The exact cause is unknown in most cases.
 cont...
 Thought to result from localized
proliferation of ductal cells in the eccrine
sweat glands.
 No strong genetic association in solitary
cases.
 May rarely develop after trauma, scarring,
or radiation therapy
 Risk Factors
 Middle-aged to older adults (most common age group)
 Chronic friction or trauma (especially on feet)
 Excessive sweating or hyperhidrosis (possibly
contributory)
 Sun exposure (less common but occasionally linked)
 Radiation exposure (in rare cases)
 Pathophysiology
 Arises from the acrosyringium, which is the intraepidermal
segment of the eccrine duct.
 Tumor shows monomorphic cells forming nests or cords, often
extending into the dermis.
 Sometimes has features like:
 Clear cell change
 Cystic spaces
 Can mimic other skin lesions (like basal cell carcinoma or squamous cell
carcinoma), especially if ulcerated.
 Signs and Symptoms
 Common sites: Soles of the feet (most common), Palms, Hands,
legs, or trunk
 Slow-growing, painless bump
 Appearance: Pink, red, or skin-colored papule/nodule
 Firm and fleshy
 Often has a moist surface or may appear vascularized
 May occasionally ulcerate or bleed, especially with trauma
 Size: usually <2 cm
cont...
 Trichilemmoma
 Trichilemmoma is a benign skin tumor derived from the outer root sheath
of hair follicles.
 It typically presents as a small, flesh-colored, wart-like growth, often on
the face (especially around the nose, cheeks, or lips).
 It may appear as a solitary lesion or be multiple.
 Multiple trichilemmomas are strongly associated with Cowden syndrome
(a genetic condition that increases the risk of various cancers).
 Benign proliferation of cells from the outer root sheath of hair [Link]
sporadic (non-genetic) cases, the cause is unknown.
 Risk Factors
 Middle-aged to older adults
 Genetic predisposition, especially:
 Cowden syndrome (PTEN gene mutation)
 Fair skin – possibly more prone to developing certain benign lesions
 Sun exposure – may play a contributing role
 Pathophysiology
 Tumor arises from the isthmus of the hair follicle.
 Histologically, it shows:
 Lobules of pale-staining cells with peripheral palisading (cells aligned at the
edge).
 Thickened basement membrane.
 Sometimes shows clear cell changes, mimicking basal cell carcinoma (but
benign).

 In Cowden syndrome, PTEN gene dysfunction causes loss of

cellular growth control, leading to multiple benign and malignant
growths.
 Signs and Symptoms
 Most often located on the central face – especially nose, upper
lip, or cheeks.
 Small, firm, skin-colored or pinkish papule (bump).
 Size: Usually <5 mm.
 Wart-like appearance.
 Painless and asymptomatic.
 Solitary or multiple lesions: Multiple lesions suggest a genetic
condition like Cowden syndrome.
CONT...
 Treatment
 Surgical Excision; Complete removal for diagnostic and cosmetic
reasons.
 and it is Curative.
 Electrosurgery or Laser Ablation : For smaller or superficial lesions.
 Monitoring: Especially in patients with Cowden syndrome —
requires long-term surveillance for breast, thyroid, and endometrial
cancers.
 Genetic Counseling: Recommended for patients with multiple
trichilemmomas or a family history of Cowden syndrome.
 General Preventive

 Sun Protection;Use sunscreen, wear hats/clothing to reduce UV-

induced skin damage.
 Avoid Skin Trauma: Minimize chronic friction or repeated injury
(especially on palms/soles).
 Skin Hygiene & Care:Clean skin regularly, avoid clogged pores and
sweat gland irritation.
 cont...
 Regular Skin Checks,Self-exams and dermatology visits
for early detection of new or changing lesions.
 Avoid Radiation Exposure: Limit unnecessary radiation
(e.g., old treatment sites can develop tumors).
 Monitor Family History: Be aware of hereditary
syndromes like Cowden or Muir-Torre.
 Genetic Counseling: Recommended if there's a family
history of syndromic conditions or multiple lesions.
 Summary Table
Type Origin Common Site Syndrome Association

1. Sebaceous Adenoma Sebaceous glands Face, scalp Muir-Torre syndrome

2. Eccrine Poroma Eccrine sweat glands Palms, soles Rare progression to cancer

3. Hidradenoma Eccrine/Apocrine glands Head, neck Rare malignancy possible

4. Trichilemmoma Hair follicle sheath Face Cowden syndrome

5. Syringoma Eccrine ducts Eyelids Common in Down syndrome

6. Apocrine Adenoma Apocrine glands Face, axilla None

7. Chondroid Syringoma Mixed glandular Head, neck None