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Adrenal cortical neoplasms histologic criteria for malignancy

F Duenschede, F Bittinger, A Heintz, T Musholt, M Korenkov, P Kann, P Ewald, I Gockel, T Junginger
BACKGROUND: The management of incidentalomas with tumor size 3 cm and larger is still under controversial discussion. STUDY DESIGN: Clinical charts of 65 patients who underwent adrenalectomy for an incidentaloma were reviewed. RESULTS: Sixty-five patients were operated. There were 28 men and 37 women with a median age of 56.9 years. Median size of all resected lesions was 4.1 cm. Indications for surgery were tumor size equal and larger than 3 cm, recurrent pain, hormone status and patients' fear of malignancy...
2008: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Jacqueline A Wieneke, Lester D R Thompson, Clara S Heffess
Adrenal cortical neoplasms in pediatric patients (<20 years) are rare. The clinical manifestations and biologic behavior of these lesions can be quite distinct from their histologically similar counterparts in the adult population, making pathologic criteria for distinguishing benign from malignant tumors equivocal. We undertook a study of 83 adrenal cortical neoplasms to determine if adult clinical and histologic features can be applied to pediatric patients in an outcome-based analysis. Most of the patients (50 girls and 33 boys) presented with hormone-related symptoms present for a mean of 6...
July 2003: American Journal of Surgical Pathology
M Venara, R Sanchez Marull, I Bergada, M Gamboni, H Chemes
Prognostic markers in pediatric adrenal cortical tumors are difficult to define. We determined the ploidy, immunostaining of p53-protein and number of nucleolar organizer regions (AgNORs) in 16 such tumors and related them to clinical outcome, tumor weight (TW) and histologic Weiss' criteria. Eleven females and 5 males aged 0.4 to 15.6 years were followed for 8.7 years; 10 presented Cushing's and 6 virilization syndrome. Diploid (n = 4, x TW = 269 g, range: 17-800 g) and near-diploid tumors (n = 3, x TW = 55 g, range: 20-85 g) had good outcome, Weiss' criteria were 0-7, and p53 reactivity was negative in all...
September 1998: Journal of Pediatric Endocrinology & Metabolism: JPEM
P Komminoth, J Roth, S Schröder, P Saremaslani, P U Heitz
BACKGROUND: The differential diagnosis of cortical versus medullary tumors of the adrenal gland may be a problem in diagnostic pathology. Conflicting results have been reported about the distribution of various immunohistochemical markers in the normal as well as neoplastic adrenal cortex and medulla. EXPERIMENTAL DESIGN: Archival, formaldehyde-fixed, and paraffin-embedded material comprising 27 adrenocortical carcinomas (ACC, meeting Weiss' histologic criteria), 28 pheochromocytomas (PCC), and adjacent nontumorous tissue (13 glands) were analyzed by immunogold-silver staining for the expression of polysialic acid (poly Sia), cytokeratins (CK), synaptophysin (SYN), chromogranin A (CrgA), somatostatin (SOM), calcitonin (CT), and the "adrenocortical marker" D11...
April 1995: Laboratory Investigation; a Journal of Technical Methods and Pathology
W Saeger
The use of immunohistochemistry and electron microscopy enables the strict separation of adreno-cortical and adreno-medullary tumors in every case, as tumors of the medulla are generally positive for neuroendocrine markers (chromogranin A, synaptophysin) and negative for D11 whereas those of the cortex are stained with D11 and are negative with the other markers. Our surgical collection of cortical tumors and tumor-like lesions (n = 104) covers adenomas (39%), carcinomas (15%), microadenomatosis (2%), macronodular hyperplasia (4%), hemangioma (1%), myelolipoma (2%), hematoma (1%), pseudocysts (2%), and metastases (6%)...
March 1995: Minerva Endocrinologica
M J Gandour, W E Grizzle
Adrenocortical carcinoma is an unusual tumor that tends to be larger than 100 g at diagnosis. Malignant adrenocortical tumors of less than 50 g have been reported rarely. We studied a small adrenocortical carcinoma that weighed 40 g and metastasized 3 1/2 years following bilateral adrenalectomy. The malignancy of adrenocortical tumors is frequently difficult to determine. Two recent studies have proposed histologic criteria for determining the malignancy of adrenal cortical tumors. Since the tumor we studied was initially judged to be benign, we sought to determine whether an extensive evaluation of this tumor using these recent criteria could have identified the tumor's potential for metastasizing...
November 1986: Archives of Pathology & Laboratory Medicine
L J Medeiros, L M Weiss
In the past decade, our knowledge of neoplasms arising in the adrenal cortex has been expanded greatly. Histologic criteria for distinguishing benign from malignant adrenal cortical neoplasms have been developed. In this review, three systems useful in making this distinction are reviewed and compared. Pathologic indicators of prognosis for adrenal cortical carcinomas have been proposed and these include mitotic rate, stage, surgical resectability, nuclear grade, and tumor size. Of these, mitotic rate appears to be the best indicator...
January 1992: American Journal of Clinical Pathology
A J Hough, J W Hollifield, D L Page, W H Hartmann
Forty-one patients with adrenal cortical tumors were evaluated retrospectively for the presence of histologic and non-histologic features associated with malignant behavior. The patients who survived operation were followed at least five years. The association of these features with subsequent metastasis was examined by both parametric and nonparametric statistical methods. Twelve criteria were statistically significant in predicting subsequent metastasis. The most significant of these were: clinical evidence of weight loss, broad fibrous bands traversing the tumor, a diffuse growth pattern, vascular invasion, tumor cell necrosis, and tumor mass...
September 1979: American Journal of Clinical Pathology
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