Advanced adenoma

Three large and some smaller RCTs have investigated the effect of folic acid on the prevention of the recurrence of colorectal adenomas. Recent metaanalyses showed that the larger trials (involving more than 1300 patients treated with placebo and more than 1300 patients treated with folic acid, with folic acid doses of 0.5-1.0mg/d and follow-up periods up to 42 months) showed no effect of folic acid on the recurrence of any adenoma (RR 0.98, 95% Cl 0.82-1.17) or advanced adenoma (RR 1.06, 95% Cl 0.81-1.39). Analyses of other outcomes (number of adenomas, adenoma size or location) also showed no difference between placebo and folic acid (Figueiredo et al. 2011). Another meta-analysis, which also included some smaller trials, derived the similar conclusion that folic acid has no effect on the recurrence of colorectal adenomas (RR 1.08, 95% Cl 0.87-1.33) (Ibrahim et al. 2010). 

The progressive transformation of adenomatous polyps to invasive adenocarcinoma has been characterized as the adenoma carcinoma sequence (Muto 1975). However, because the prevalence of undetected cancer in an asymptomatic screening population is very low at ca.1%, colon polyp size is widely accepted as a surrogate end point for outcomes assessment in colorectal cancer screening programs. Thus, the concept of the advanced adenoma has been developed which is defined as an adenomatous polyp measuring 10 mm or greater... 

Winawer S, Zauber A (2002) The advanced adenoma as the primary target of screening. Gastrointest Endosc Clin North Am 1212 1-9... 

C3. Polyp, possibly advanced adenoma followup colonoscopy recommended C4. Colonic mass, likely malignant surgical consultation recommended ... 

ECD is nearly always associated with hypertrophy, adenomatous h3q>erplasia or, in the most advanced cases, a functional adenoma of the pars intermedia of the pituitary gland. This condition was first described in 1932 however the exact pathogenesis, diagnostic plan and appropriate treatment regimen are still under dispute. Although, all breeds of horses and both sexes... 

Duvia et al. "Advances in the Phytotherapy of Prostatic Hypertrophy." The effectiveness and tolerability of saw palmetto extract was compared with pygeum (Prunus ajricanium) extract in 30 patients with prostatic adenomas. The saw palmetto was superior to the pygeum in reducing symptoms, and it was much better tolerated. The Serenoa did not produce any side effects, while the pygeum caused gastric upset in 13 percent of the patients. 

Figure 3.58 (a) Side view of a pituitary gland adenoma, (b) Top view (slice) of the adenoma. (Images courtesy of H.T. Alberry, D. Derico, and M. Farrell, Albany Advanced Imaging, Albany, NY.)... 

Flat adenomas measuring 6 mm or greater are, however, uncommon in a typical Western screening population, and advanced neoplasms are rare. Flat lesions should therefore not be considered a significant drawback for virtual colonoscopy screening (Pickhardt et al. 2004b). 

Mucinous cystadenoma usually occur in women. In contrast to (the always benign) serous cystadenoma, mucinous tumors represent a histologic spectrum, ranging from adenoma, borderline tumor to non-invasive and invasive carcinoma. With advancing age, the histologic grade of the tumor tends to worsen. The CT appearance is always macrocystic (therefore the synonym... 

Advances A. M. Landolt Progress in Pituitary Adenoma Biology. Results of Research and Clinical Applications. — J. Hildebrand and J. Brihaye Chemotherapy of Brain Tumours. — S. Mingrino Supratentorial Arteriovenous Malformations of the Brain. 

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