Clinicopathological Description of 43 Oncocytic Adrenocortical Tumors: Importance of Ki-67 in Histoprognostic Evaluation

Mod Pathol. 2018 Nov;31(11):1708-1716. doi: 10.1038/s41379-018-0077-8. Epub 2018 Jun 19.

Abstract

Oncocytic adrenocortical tumors are a rare subtype of adrenal tumors with challenging diagnosis and histoprognostic assessment. It is usually believed that oncocytic adrenocortical tumors have a more indolent clinical behavior than conventional adrenocortical tumors. As the Weiss score overestimates the malignancy of oncocytic adrenocortical tumors owing to intrinsic parameters, alternative scores have been proposed. The Lin-Weiss-Bisceglia score is currently recommended. We performed a large nationwide multicenter retrospective clinicopathologic study of oncocytic adrenocortical tumors. Among the 43 patients in our cohort, 40 patients were alive without disease, 2 patients died of their disease and 1 patient was alive with relapse after a median follow-up of 38 months (20-59). Our data revealed that over 50% of the oncocytic adrenocortical tumor cases were diagnosed as carcinoma whatever the classification systems used, including the Lin-Weiss-Bisceglia score. The exception is the Helsinki score, which incorporates the Ki-67 proliferation index and was the most specific prognostic score for oncocytic adrenocortical tumor malignancy without showing a loss in sensitivity. A comparison of malignant oncocytic adrenocortical tumors with conventional adrenocortical carcinomas matched for age, sex, ENS@T stage and surgical resection status showed significant better overall survival of malignant oncocytic adrenocortical tumors.

MeSH terms

  • Adenoma, Oxyphilic / pathology*
  • Adrenal Cortex Neoplasms / pathology*
  • Adult
  • Biomarkers, Tumor / analysis*
  • Female
  • Humans
  • Ki-67 Antigen / biosynthesis*
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies

Substances

  • Biomarkers, Tumor
  • Ki-67 Antigen