Adrenocortical oncocytoma: Review of imaging and histopathological implications

Abstract

Oncocytomas are rare tumours of the adrenal glands whose malignant potential is difficult to assess with certainty. We report a case of an adrenal oncocytoma and present a review of the literature particularly with regards to the radiological and histopathological features and their impact on the management.Adrenal oncocytomas are usually identified incidentally on imaging and can achieve large sizes. They should be considered in the differential diagnosis of any large upper abdominal lesion including those apparently arising from the liver as in this case report. MRI scan appears to be the ideal imaging modality to characterise such lesions. There seems to be little benefit in biopsying these masses and surgery remains the most optimal management. It remains difficult to predict metastatic behaviour based on histological findings and so long term surveillance is advisable.

Keywords: Adrenal incidentaloma; Adrenal oncocytoma; Adrenal tumour; Adrenocortical oncocytoma.

Fig. 1

CT demonstrating large right sided lesion suggestive of a liver lesion (arrow).

Fig. 2

MRI demonstrating the lesion (arrow) to arise from the adrenal gland.

Fig. 3

Macroscopic appearance of the oncocytoma with compressed residual adrenal (arrow).

Fig. 4

High power view (40×) showing polygonal adrenal cortical cells with abundant eosinophilic cytoplasm. (Haematoxylin and eosin, H&E stain).