Adnexa refers to the appendages of organs, specifically of the skin, eyes, and uterus. Adnexal neoplasms are tumors that grow in these regions. Most of them are benign, but some varieties are known to become malignant and aggressive.
Skin adnexal tumors (SATs) commonly affect the sweat glands and the pilosebaceous unit, which consists of the hair shaft, hair follicle, and the erector pili muscle.
Optical adnexal tumors usually occur in the tear glands and the eyelids, while uterine adnexal tumors affect the tubes and the ovaries. Because they affect a varied group of organs, adnexal neoplasms are hard to classify and often wrongly diagnosed.
Adnexal & Skin Appendage Neoplasms Risk Factors
Scientists aren’t sure what causes adnexal tumors, but age and gender seem to be the common risk factor. Middle-aged women are more likely to develop tumors at any of the adnexal sites, although skin tumors appear to affect men and women equally. Uterine adnexat tumors are also more likely to become malignant in older women.
Adnexal & Skin Appendage Neoplasms Signs and Symptoms
Skin and eye adnexal tumors usually appear as visible yellow bumps on the affected area. In the early stages, they are hardly noticeable and are often mistaken as harmless swelling. Most patients only get medical attention when the tumors are large enough to cause discomfort, or in the case of eye tumors, when it interferes with vision.
Uterine adnexal tumors rarely produce symptoms unless they grow to a considerable size or become malignant. The first symptom is often abdominal pain, followed by irregular menstruation and frequent cramps. Less common signs include fever, nausea, and a slight, odorless discharge.
Adnexal & Skin Appendage Neoplasms Diagnosis and Staging
Visible adnexal tumors are usually diagnosed through a simple biopsy. For uterine adnexal tumors, the doctor may use various imaging techniques to locate the tumor before taking any invasive steps. X-rays and ultrasounds can show the presence of the tumor (often incidentally), and a CT scan or MRI scan can identify the nature, size and exact location of the tumor.
Biopsies are only performed on uterine adnexal tumors if they are likely to contain cancerous cells. If the tumor is found to be malignant, the doctor may perform additional tests to determine the stage and see if it has spread to other organs.
Adnexal & Skin Appendage Neoplasms Outlook
Since most tumors are benign, the prognosis is usually excellent for adnexal tumors. Surgery can present a complete cure for most cases. Malignant adnexal tumors have a much lower survival rate. The outlook ranges from a few weeks to more than a year, depending on how far the tumor has spread. A rare variety of SAT, known as microcystic adnexal carcinoma, is very aggressive and can cause fatal complications if not treated immediately.
Adnexal & Skin Appendage Neoplasms Treatment
Benign adnexal tumors can be treated by surgical removal, with a very low chance of recurrence. If the tumor is too large or if parts of it are inaccessible, the doctor may opt for surgical debulking, or removing as much of the mass as possible. Localized radiotherapy can be used to remove the rest of the tumor.
If surgery is not an option, the doctor may opt for less invasive options, such as laparoscopic surgery. In this procedure, the tumor is removed through tiny incisions made over the affected area. This is usually preferred for early-stage uterine adnexal tumors, as it reduces the risk of complications and minimizes blood loss for the patient.
Treatment is more complicated for malignant adnexal tumors. Surgical removal is usually followed by radiotherapy and/or chemotherapy to kill any remaining cancer cells. Some patients may also need “second look” surgery shortly after the treatment, which ensures that the cancer hasn’t returned or spread.
Adnexal & Skin Appendage Neoplasms Prevention
There is no specific line of prevention for adnexal tumors, since there are no known causes. People who have at least one risk factor should be screened at least once a year. Those with a family history of tumors in any of the adnexal sites should also get regular tests, so that any unusual masses can be spotted early.