Generality
Epithelioma is the name of the class of tumors that affects the epithelium.
Epithelioma is a tumor that can be benign or malignant and owes its characteristics to the type of epithelial cell from which it originates.
The appearance of an epithelioma is correlated, as happens with all the other classes of tumors, to a series of DNA mutations, which alter the capacity of a cell to grow and divide in a controlled way.
Some of the best known epitheliomas are adenomas - which are benign tumors - and carcinomas - which are malignant tumors.
Short review of what a tumor is
In medicine, the term " tumor " and its synonym " neoplasia " identify a mass of abnormal cells (called insane cells), whose rhythm of division and growth is greater than normal.
A tumor can be benign or malignant:
- It is benign, when its crazed cells present a rhythm of division and growth moderately higher than normal and do not have the capacity to invade the surrounding tissues or even to reach the bloodstream (giving rise to metastases).
- Instead, it is malignant, when its mad cells present a rhythm of division and growth that is clearly higher than normal and are capable of affecting the surrounding tissues and spreading throughout the rest of the body, through the blood.
What is an Epithelioma?
" Epithelioma " is the medical-oncological term that identifies all benign tumors and all malignant tumors of the epithelium .
The epithelium, or epithelial tissue, is the characteristic layer of cells, which, in the human body, covers the outer surface of the skin and the inner surface of all the hollow organs (including glands).
Causes
How do tumors develop, including epithelioma?
The human body contains just over 37 trillion cells . These cells have a life cycle that includes a phase of growth, a phase of division and a phase of death and replacement with new cells of the same type.
The entire life cycle of a generic human body cell depends on the genetic heritage contained in the so-called cellular nucleus of the same cell, a genetic heritage known as DNA .
DNA is a highly efficient and precise "machine" capable of accurately directing and controlling all the most important phases of a cell's life, from birth to death.
The tumors - including epithelioma - are the result of permanent alterations ( mutations ) of the DNA, the peculiarity of which is to make the same DNA incapable of regulating the cellular processes of growth, division and death with precision and accuracy; from this it follows, as can be guessed, that the cell or cells involved in the mutation of the genetic heritage grow and divide uncontrollably ( uncontrolled cell proliferation ), becoming the so-called mad cancer cells .
A FEW DETAILS IN MORE THAN MUTATIONAL PROCESSES
To cause any tumor - including epithelioma - is never a single DNA mutation, but a series of mutations .
Generally, the mutations that cause a tumor in a human being appear at different times in life; in other words, the uncontrolled cellular proliferation, typical of tumors, is the result of a slow accumulation of mutations, by the genetic heritage, during the organism's aging process.
The fact that the development of a benign or malignant tumor takes a long time explains why the patients are, except in special cases, middle-aged or elderly adults ; young people with a tumor are very unlucky individuals, because, for them, the accumulation of mutation by DNA has been very rapid.
NB: picture above described on the accumulation of mutation has particular validity for malignant tumors; a malignant tumor is a classic example of a neoplastic process due to numerous mutational steps, which occur throughout life.
Types
Epithelioma is a tumor of which there are benign versions and malignant versions.
The most representative example of benign epithelioma is adenoma, while the most representative example of malignant epithelioma is carcinoma .
Adenoma: what is it?
In the field of oncology, any benign epithelioma takes its name from the epithelial cells of the exocrine glandular organs or from epithelial cells of tissues with secretory properties.
Among the most common and known adenomas, include: pituitary adenoma, colon adenoma, thyroid adenoma, parathyroid adenoma, adrenal adenoma, renal adenoma and breast adenoma .
Carcinoma: what is it?
In oncology, any malignant epithelioma arising from the uncontrolled proliferation of a generic epithelial cell takes on the name of carcinoma.
Since an epithelium includes different types of cells and since carcinomas have different characteristics depending on the cell of origin, the doctors have drawn up a typological classification of the carcinoma which includes:
- Squamous cell carcinoma . This type of malignant epithelioma originates from the so-called squamous cells . Flattened in shape, squamous cells characterize the outermost layers of the skin (namely the epidermis), the surface of the oral cavity (including the tongue) and the throat, and the internal wall of organs such as the esophagus, colon and rectum.
Most common sites of squamous cell carcinoma: skin, mouth, tongue, throat and esophagus.
- Adenocarcinoma . Adenocarcinomas are malignant epitheliomas originating from epithelial cells with secretory properties belonging to the exocrine glands.
Adenocarcinoma is the malignant version of the benign epitelioma known as adenoma.
Most common sites of adenocarcinoma: breast, pancreas, colon, rectum, prostate and lung (bronchial tree and pulmonary acini).
- Transitional cell carcinoma (or transitional carcinoma ). These malignant epitheliomas originate from the cells constituting the so-called transitional epithelia .
Transitional epithelia are particular cellular formations, able to stretch out and have impermeability; generally, they locate along the urinary tract, covering the inner wall of the bladder or part of the urethra.
Most common sites of transitional carcinoma: bladder and urethra.
- Basal cell carcinoma . These tumors represent a genus of malignant epithelioma that arises from basal cells .
Basal cells are cubic or cylindrical cellular elements, located at the base of the epidermis, in direct contact with the underlying dermis.
Most common sites of basal cell carcinoma: skin.
To remember…
In the oncological field, a type of epithelial cell from which the malignant epithelioma in question originates is distinguished by a carcinoma.
Symptoms
Epithelioma is a tumor whose symptoms vary according to the epithelium of origin.
In practical terms, this means that an epithelioma on the skin causes symptoms different from an epithelioma on the parathyroid gland.
Diagnosis
The diagnosis of an epithelioma tends to be based on:
- The physical examination;
- The medical history;
- The patient's account of symptoms;
- Diagnostic imaging;
- Tumor biopsy.
The precise diagnostic procedure that allows to recognize an epithelioma and describe its characteristics is strictly dependent on the epithelium of origin of the neoplasm.
Therapy
Treatment of an epithelioma depends on various features of the neoplasm, including the epithelium of origin (hence the site) and the stage of progress.
Among the therapeutic techniques most used for the treatment of an epithelioma, include: surgical removal of the tumor mass, radiotherapy (exposure of the tumor mass to ionizing radiation, with the intent to kill abnormal cells) and chemotherapy (drugs that kill cells characterized by out-of-control growth, such as cancer ones).
Prognosis
On the prognosis of an epithelioma depend factors such as:
- The benign or malignant nature of the neoplasm. A malignant epithelioma is certainly more dangerous than a benign epithelioma, especially because the spread of metastasis in the rest of the body may depend on it. It should, however, be remembered that there are benign epitheliomas which, although lacking in invasive capacity, are nevertheless capable of causing symptoms incompatible with a normal life (eg: benign epitheliomas affecting the pituitary gland or benign epitheliomas affecting the parathyroid gland);
- The stage of progression of the tumor (in the case in which the epitelioma is malignant);
- The epithelium of interest;
- The timeliness of the diagnosis (particularly important in the case in which the epitelioma is malignant).
Important examples
This chapter is devoted to a broader description of some common epitheliomas.
Specifically, the reader will be able to investigate the benign epitelioma known as breast adenoma and the two malignant epitheliomas of the skin that affect, one, the squamous cells ( squamous cell carcinoma of the skin ) and, the other, the basal cells (basal cell carcinoma of the skin ).
Breast adenoma
Also known as breast fibroadenoma, breast adenoma is a benign epithelioma, which originates from the unusual proliferation of an epithelial cell of the glandular tissue of the breast (due to the precision of the glandular tissue that makes up the so-called breast lobules).
Currently, the cause of breast adenoma is unknown; on the subject, however, various theories exist, the most reliable of which imputes to an excess of estrogens in the organism the role of crucial favoring factor (in support of this theory there is the evidence that breast adenoma has a preference for women between the ages of 15 and 30, ie the category of women with the highest levels of circulating estrogen).
The breast adenoma is not visible to the naked eye from the outside, but is palpable; on palpation, it may resemble a lump or a ball and may appear as something rubbery or rigid.
In general, breast adenoma is a completely harmless tumor that does not require any special treatment; however, there are some sporadic cases of adenoma in the breast, in which the neoplasm in question suddenly becomes malignant (or has some benign and partly malignant characters) and requires its removal through surgical intervention.
Did you know that ...
Breast adenomas that have a greater tendency to become malignant epitheliomas are those that contain liquid-filled cysts and calcium deposits in them .
Fortunately, these breast adenomas - which are defined as complex breast adenomas - are uncommon.
Women with a complex breast adenoma are required to undergo periodic medical checks (to monitor epitelioma) and, possibly, a surgical operation to preventively remove the tumor mass.
Basal cell carcinoma of the skin
Basocellular carcinoma of the skin is the malignant tumor that originates from the uncontrolled proliferation of one of the basal cells of the epithelium of the epidermis (outer cellular layer of the skin).
The basal cells of the epithelium of the skin are cubic-shaped cells, which reside at the base of the layers constituting the epidermis, in direct contact with the cells of the so-called dermis.
The basal cells have a very intense replicative activity, fundamental for the periodic cellular replacement that the skin needs.
A member of the category of skin cancers other than melanoma, basal cell carcinoma is, in most cases, a consequence of excessive exposure to UV light from the sun or tanning lamps and, to a lesser extent, a consequence of the immunodepression that arises from condition like leukemia and AIDS.
Several risk factors are associated with basal cell carcinoma of the skin, including: fair skin, the tendency to expose oneself to the sun in the hottest hours and without an adequate protective cream, immunosuppression and genetic predisposition to skin cancers.
To characterize the presence of a basal cell carcinoma of the skin is a small sign on the skin, which can appear as:
- A protuberance of pearl white or waxy white;
- A scaly area, not particularly noticeable, brown or flesh-colored;
- A scar-colored scar-colored lesion.
With the sign just described, basal cell carcinoma can affect any part of the body; however, the statistics say that he has a preference for the skin areas most exposed to the sun (ie face, back of hands, scalp, neck and ears).
For a definitive diagnosis of an epithelioma such as basal cell carcinoma of the skin, a biopsy on a sample of cells of the abnormal cutaneous sign is always indispensable.
The treatment of basal cell carcinoma of the skin is based on the total removal of the formed skin anomaly; currently, the removal techniques are numerous and include, among others: curettage combined with electrocautery, surgical excision, photodynamic therapy, cryotherapy, topical chemotherapy, radiotherapy and laser therapy .
Did you know that ...
Basal cell carcinoma of the skin is known by several names, including: basal cell and basalioma epithelioma .
Skin Squamous Carcinoma
Also known as spinocellular skin carcinoma and squamous cell epithelioma of the skin, squamous cell carcinoma of the skin is the malignant tumor that originates from the uncontrolled proliferation of one of the squamous cells of the epithelium of the epidermis.
The squamous cells of the epithelium of the skin are generally flat cells, which take place in the most superficial layers of the epidermis.
Squamous cells have a limited life; in fact, a few weeks after their formation, they die to make room for new scaly cells that are completely identical to the previous ones.
Belonging to the category of skin cancers other than melanoma, squamous carcinoma recognizes the excessive exposure to UV light from the sun or tanning lamps and the state of immunodepression, which can result from diseases such as leukemia or AIDS, as the main causative factors. .
The squamous carcinoma of the skin has the same risk factors previously reported for basal cell carcinoma of the skin.
To distinguish the squamous carcinoma of the skin is a small sign on the skin, which may look like:
- A red nodule of stiff consistency;
- A scaly and crusty plague;
- An ulcerative lesion that never heals;
- A wart.
Squamous cell carcinoma of the skin can occur anywhere; it is a fact, however, that - just like basal cell carcinoma of the skin - it has a preference for areas of skin most exposed to the sun.
Squamous cell carcinoma of the skin is a tumor whose definitive diagnosis always requires a bioptic examination on a sample of cells coming from the abnormal cutaneous sign.
The treatment of squamous carcinoma of the skin revolves around the complete removal of the abnormal sign on the skin; the removal techniques available today are the same as those used in the treatment of basal cell carcinoma of the skin (therefore curettage combined with electrocautery, surgical excision, etc.).
Did you know that ...
Sometimes, the appearance of squamous cell carcinoma of the skin is preceded by a carcinoma in situ - which is not a purely malignant epithelioma - known as Bowen's disease .
