Adrenal cortical carcinoma: pathology, genomics, prognosis, imaging features, and mimics with impact on management

Ahmed, A.A.; Thomas, Aaron J.; Ganeshan, Dhakshina Moorthy; Blair, Katherine J.; Lall, Chandana; Lee, James T.; Morshid, Ali; Habra, Mouhammed Amir; Elsayes, Khaled M.

doi:10.1007/s00261-019-02371-y

Cited by 37 publications

(41 citation statements)

References 111 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…But OS was not improved due to gastrointestinal and neurologic toxicity. Targeted therapy was gradually recognized, whereas its clinical effect was also unsatisfactory [39,40] . This may be due to the multiple molecular pathways involved in the pathogenesis of ACC, which may make different drug classes effective in only a small subgroup of patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Summary of clinical characteristics of common primary adrenal malignancies in adults

zhang¹,

wang²,

Li³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background To summary the clinical characteristics of common primary adrenal malignancies in adults, the survival time of the patients, and the prognostic factors associated with these rare malignancies. Methods The Surveillance, Epidemiology, and End Results database (1975–2016) was queried for all patients who were diagnosed with primary adrenal malignancies, including adrenocortical carcinoma(ACC), pheochromocytoma and paraganglioma (PPGL), lymphoma, and sarcoma (SA). The clinical characteristics, overall survival (OS) and cancer-specific survival (CSS) were analyzed, in which propensity score methodology, logistic regression modeling and Kaplan-Meier survival curves were used. The Multivariate Cox proportional hazard model was used to identify factors affecting the prognosis of patients with ACC. Results 3204 patients with primary adrenal malignancies were identified, including 2180 with ACC, 593 with PPGL, 307 with lymphoma, and 124 with SA. Generally, PPGL had a better prognosis than others. For ACC and PPGL, the non-metastatic group had better OS and CSS than the metastatic group; for SA, the non-metastatic group had better OS, however, there was no significant difference in CSS between the two groups. Furthermore, For ACC, the single metastasis group had a better OS than the multiple metastasis group. After tumors metastasis, the surgery group, surgery of primary adrenal lesions, had better OS and CSS than the non-surgery group for ACC and PPGL. For lymphoma, the chemotherapy group had better OS and CSS; for ACC and PPGL, the chemotherapy group had better CSS and worse OS; for SA, the survival showed no significant difference between the two groups. Radiotherapy had the same effect on patients' survival as chemotherapy, except for the lymphoma and the ACC. As for lymphoma, the radiotherapy group had better CSS, whereas the survival showed no significant difference in OS between the two groups. For ACC, the non- radiotherapy group had better CSS and OS. More importantly, for lymphoma, under the condition that both cohorts were the same basically, the surgical group had a better prognosis. The prognosis of ACC was related to sex, age, seer historic stage, surgery, chemotherapy. Conclusion Understanding the clinical characteristics of these tumors and factors affecting prognosis can facilitate the selection of more appropriate clinical treatment options.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Furthermore, based on advancing research, pathological markers such as the Ki67 index were also important prognostic indicators for ACC [37,40,55] . What's more interesting was that the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) might be new biomarkers for predicting the prognosis of adrenal tumor patients.…”

Section: Discussionmentioning

confidence: 99%

Summary of clinical characteristics of common primary adrenal malignancies in adults

zhang¹,

wang²,

Li³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Adrenocortical carcinoma often metastasizes to the liver, lymph nodes, lung, brain, and other places at an early stage (43). Tumor tissues on enhancement CT are poorly enhanced or show an irregular intensification and peripheral ring, with a slow decrease in intensity during the delayed phase (44).…”

Section: Adrenocortical Carcinomamentioning

confidence: 99%

Virtual or real: lifelike cinematic rendering of adrenal tumors

Tang¹,

Wang²,

Yang³

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

The adrenal gland is small in size and hidden in location. Adrenal tumors are relatively difficult to diagnose due to the wide variety of tumors and partial overlap of image features. Cinematic rendering (CR) is a novel, three-dimensional post-processing technology that simulates how light propagates in the real world, providing high-resolution visualizations that truly present subtle anatomical details. We retrospectively collected a series of pathologically confirmed adrenal tumor cases, raw data was introduced into the post-processing workstation, and different tools and templates of CR software were used for reconstruction and rendering. Compared with traditional black and white two-dimensional images and three-dimensional volume rendering (VR) images, CR images were more colorful, layered, and closer to the truth. CR has potential in diagnosing and preoperative planning of adrenal tumors, allowing vivid and realistic visualization of tumor location, morphology, different components (solid, cystic, fat, calcification, etc.), the pattern of enhancement, and the relationship with surrounding tissues and organs.

show abstract

“…The Surveillance, Epidemiology, and End Results (SEER) registry reported that the incidence of ACC in the United States was one per million people annually from 1974 to 2014 [ 2 ]. Although radical surgical resection is the most effective therapy, 5-year survival rates of ACC patients range from 15% to 44% [ 3 ]. Therefore, it is warranted to identify an improved prognostic feature to predict the prognosis for ACC patients and then assign them to appropriate therapeutic interventions.…”

Section: Introductionmentioning

confidence: 99%

A Hypoxia Signature for Predicting Prognosis and Tumor Immune Microenvironment in Adrenocortical Carcinoma

Chen

Yan

et al. 2021

Journal of Oncology

View full text Add to dashboard Cite

Adrenocortical carcinoma (ACC) is a rare malignancy with dismal prognosis. Hypoxia is one of characteristics of cancer leading to tumor progression. For ACC, however, no reliable prognostic signature on the basis of hypoxia genes has been built. Our study aimed to develop a hypoxia-associated gene signature in ACC. Data of ACC patients were obtained from TCGA and GEO databases. The genes included in hypoxia risk signature were identified using the Cox regression analysis as well as LASSO regression analysis. GSEA was applied to discover the enriched gene sets. To detect a possible connection between the gene signature and immune cells, the CIBERSORT technique was applied. In ACC, the hypoxia signature including three genes (CCNA2, COL5A1, and EFNA3) was built to predict prognosis and reflect the immune microenvironment. Patients with high-risk scores tended to have a poor prognosis. According to the multivariate regression analysis, the hypoxia signature could be served as an independent indicator in ACC patients. GSEA demonstrated that gene sets linked to cancer proliferation and cell cycle were differentially enriched in high-risk classes. Additionally, we found that PDL1 and CTLA4 expression were significantly lower in the high-risk group than in the low-risk group, and resting NK cells displayed a significant increase in the high-risk group. In summary, the hypoxia risk signature created in our study might predict prognosis and evaluate the tumor immune microenvironment for ACC.

show abstract

Adrenal cortical carcinoma: pathology, genomics, prognosis, imaging features, and mimics with impact on management

Cited by 37 publications

References 111 publications

Summary of clinical characteristics of common primary adrenal malignancies in adults

Summary of clinical characteristics of common primary adrenal malignancies in adults

Virtual or real: lifelike cinematic rendering of adrenal tumors

A Hypoxia Signature for Predicting Prognosis and Tumor Immune Microenvironment in Adrenocortical Carcinoma

Contact Info

Product

Resources

About