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Oncocytic Adreno Cortical Tumors: Pathological Features of 16 Cases and Review of the Literature.

Abstract Oncocytic neoplasms of the adrenal gland are extremely rare tumors. These tumors differ from their nononcocytic counterparts in some respects. The aim of this study was to review and discuss the clinical, histological, and immunohistochemical features of as well as the prognosis for these rare tumors. In total, 16 cases diagnosed as adrenocortical oncocytic neoplasms between January 2011 and December 2016 were included in the study. The demographic data, gross characteristics, histological data, and immunohistochemical data (Chromogranin-A, Synaptophysin, α-Inhibin, Melan-A, Ki67, PHH3) were reevaluated. The follow-up data for these patients were added in January 2017. Of the 16 cases, 12 were adrenocortical adenoma, 1 was borderline adrenocortical tumor, and 3 were adrenocortical carcinoma. The tumors equally affected both genders. The tumors were not generally large. Tumor cells had pleomorphic nuclei in ten cases, but it was more obvious in one case. The mitotic figure count was low in most tumors. Atypical mitosis and necrosis were observed in three and four tumors, respectively. None of cases included sinusoidal invasion, vascular invasion, or capsular invasion. We detected the expression of at least one specific marker (e.g., Melan-A, Inhibin-α) of the adrenal cortex in all tumors. None of the tumors were immunoreactive for Chromogranin-A. Ki-67 proliferation index was lower than 5% in all cases except three oncocytic carcinomas. In two cases, PHH3 positivity was not seen, while it was lower than 3 of 10 high-powered fields in ten cases and higher in 4 cases. All patients were alive and disease free except for two patients with adrenocortical carcinoma. In conclusion, determining the clinical, histological, and immunohistochemical characteristics of these extremely rare tumors can provide important information for early diagnosis, treatment, and follow-up of these cases.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title journal of environmental pathology, toxicology and oncology : official organ of the international society for environmental toxicology and cancer
Publication Year Start




PMID- 29283337
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20180104
IS  - 2162-6537 (Electronic)
IS  - 0731-8898 (Linking)
VI  - 36
IP  - 3
DP  - 2017
TI  - Oncocytic Adreno Cortical Tumors: Pathological Features of 16 Cases and Review of
      the Literature.
PG  - 237-244
LID - 10.1615/JEnvironPatholToxicolOncol.2017021895 [doi]
AB  - Oncocytic neoplasms of the adrenal gland are extremely rare tumors. These tumors 
      differ from their nononcocytic counterparts in some respects. The aim of this
      study was to review and discuss the clinical, histological, and
      immunohistochemical features of as well as the prognosis for these rare tumors.
      In total, 16 cases diagnosed as adrenocortical oncocytic neoplasms between
      January 2011 and December 2016 were included in the study. The demographic data, 
      gross characteristics, histological data, and immunohistochemical data
      (Chromogranin-A, Synaptophysin, alpha-Inhibin, Melan-A, Ki67, PHH3) were
      reevaluated. The follow-up data for these patients were added in January 2017. Of
      the 16 cases, 12 were adrenocortical adenoma, 1 was borderline adrenocortical
      tumor, and 3 were adrenocortical carcinoma. The tumors equally affected both
      genders. The tumors were not generally large. Tumor cells had pleomorphic nuclei 
      in ten cases, but it was more obvious in one case. The mitotic figure count was
      low in most tumors. Atypical mitosis and necrosis were observed in three and four
      tumors, respectively. None of cases included sinusoidal invasion, vascular
      invasion, or capsular invasion. We detected the expression of at least one
      specific marker (e.g., Melan-A, Inhibin-alpha) of the adrenal cortex in all
      tumors. None of the tumors were immunoreactive for Chromogranin-A. Ki-67
      proliferation index was lower than 5% in all cases except three oncocytic
      carcinomas. In two cases, PHH3 positivity was not seen, while it was lower than 3
      of 10 high-powered fields in ten cases and higher in 4 cases. All patients were
      alive and disease free except for two patients with adrenocortical carcinoma. In 
      conclusion, determining the clinical, histological, and immunohistochemical
      characteristics of these extremely rare tumors can provide important information 
      for early diagnosis, treatment, and follow-up of these cases.
FAU - Ertan, Yesim
AU  - Ertan Y
AD  - Department of Pathology, Ege University, Izmir, Turkey.
FAU - Argon, Asuman
AU  - Argon A
AD  - Department of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir,
      Turkey.
FAU - Ozdemir, Murat
AU  - Ozdemir M
AD  - Department of General Surgery, Ege University, Izmir, Turkey.
FAU - Yurekli, Banu Pinar Sarer
AU  - Yurekli BPS
AD  - Department of Endocrinology, Ege University, Izmir, Turkey.
FAU - Dokumcu, Zafer
AU  - Dokumcu Z
AD  - Department of Pediatric Surgery, Ege University, Izmir, Turkey.
FAU - Makay, Ozer
AU  - Makay O
AD  - Department of General Surgery, Ege University, Izmir, Turkey.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Environ Pathol Toxicol Oncol
JT  - Journal of environmental pathology, toxicology and oncology : official organ of
      the International Society for Environmental Toxicology and Cancer
JID - 8501420
RN  - 0 (Chromogranin A)
RN  - 0 (Ki-67 Antigen)
SB  - IM
MH  - Adolescent
MH  - Adrenal Cortex Neoplasms/chemistry/*pathology
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Chromogranin A/analysis
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - Infant
MH  - Infant, Newborn
MH  - Ki-67 Antigen/analysis
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2017/12/29 06:00
MHDA- 2018/01/05 06:00
CRDT- 2017/12/29 06:00
PHST- 2017/12/29 06:00 [entrez]
PHST- 2017/12/29 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
AID - 1828aa871383557b,546bf4df63a3f7c7 [pii]
AID - 10.1615/JEnvironPatholToxicolOncol.2017021895 [doi]
PST - ppublish
SO  - J Environ Pathol Toxicol Oncol. 2017;36(3):237-244. doi:
      10.1615/JEnvironPatholToxicolOncol.2017021895.