Adrenocortical cancer: morphological variants, immunohistochemical characteristics

Tkachuk, A. V.; Тертычный, А. С.; Бельцевич, Д. Г.; Roslyakova, Anna; Belousov, Pavel V.; Selivanova, L S

doi:10.17116/patol20218302110

Cited by 8 publications

(4 citation statements)

References 15 publications

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“…Согласно классификации ВОЗ, выделяют несколько морфологических вариантов АКР. При этом даже в пределах классического гистологического варианта идентифицированы различные морфологические особенности: преобладание крупных полиморфных клеток, мономорфных клеток малого или среднего размера («карциноидоподобных») или рабдоидных клеток, формирующих альвеолярные структуры [ 12 ].…”

Section: Discussionunclassified

Metastatic lesions of the adrenal glands. The experience of Endocrinology Research Center.

Pachuashvili,

Roslyakova,

Porubayeva

et al. 2023

Probl Endokrinol (Mosk)

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Differentiation between benign, primary and secondary malignant tumors is a critical problem in the clinical treatment of adrenal tumors, especially in patients with isolated adrenal lesions. In most cases, the correct diagnosis can be established microscopically with standard staining with hematoxylin and eosin. However, there are cases when it is almost impossible to distinguish metastasis from primary adrenal cancer, so an accurate diagnosis requires an immunohistochemical examination.This article presents five unique observations of secondary adrenal tumors that were diagnosed by us in the current surgical material: metastasis of clear cell renal cell carcinoma, follicular variant of papillary thyroid cancer, metastasis of keratinizing squamous cell carcinoma of the cervix, lymphoepithelioma-like carcinoma of the bladder, as well as malignant mesothelioma. Taking into account the extreme rarity of the presented observations, we present an analysis of the literature data.

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Section: Discussionunclassified

Metastatic lesions of the adrenal glands. The experience of Endocrinology Research Center.

Pachuashvili,

Roslyakova,

Porubayeva

et al. 2023

Probl Endokrinol (Mosk)

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“…There are three histologic variations of ACC in addition to the conventional ACC: oncocytic, myxoid, and sarcomatoid. A myxoid variant is an uncommon variant of ACC that accounts for 10% of all ACC cases [10,11]. It is characterized by the variably abundant extracellular myxoid components (5-90%) resembling carcinomas with extracellular mucin secretions or myxoid tumors.…”

Section: Histology Of Acc and Myxoid Variantmentioning

confidence: 99%

Metastatic Adrenocortical Carcinoma With Chromothripsis: A Case Report and Literature Review

Seong,

Wu,

Kim

et al. 2023

Cureus

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Metastatic adrenocortical carcinoma (ACC) often has a poor outcome, with a five-year survival of less than 25%. We report a rare case of metastatic ACC with a myxoid variant with chromothripsis. We review the histologic variants of ACC, including myxoid type, molecular drivers, and current and investigational therapies for adrenocortical carcinoma. We also discuss the mechanism of chromothripsis, chromothripsis in ACC tumorigenesis, and propose potential therapies targeting chromothripsis.

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“…In recent years, ACC has been considered as a heterogeneous group of diseases with various pathomorphological and genomic features, which causes variability in the clinical picture and prognosis for patients ( 4 ). An accurate scale for assessing the malignant potential of a tumor is extremely important for deciding on the appointment of adjuvant therapy and determining the features of follow-up of the patient, as well as for predicting immediate and long-term outcomes ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

The new histological system for the diagnosis of adrenocortical cancer

et al. 2023

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IntroductionAdrenocortical cancer (ACC) is a rare malignant tumor that originates in the adrenal cortex. Despite extensive molecular-genetic, pathomorphological, and clinical research, assessing the malignant potential of adrenal neoplasms in clinical practice remains a daunting task in histological diagnosis. Although the Weiss score is the most prevalent method for diagnosing ACC, its limitations necessitate additional algorithms for specific histological variants. Unequal diagnostic value, subjectivity in evaluation, and interpretation challenges contribute to a gray zone where the reliable assessment of a tumor’s malignant potential is unattainable. In this study, we introduce a universal mathematical model for the differential diagnosis of all morphological types of ACC in adults.MethodsThis model was developed by analyzing a retrospective sample of data from 143 patients who underwent histological and immunohistochemical examinations of surgically removed adrenal neoplasms. Statistical analysis was carried out on Python 3.1 in the Google Colab environment. The cutting point was chosen according to Youden’s index. Scikit-learn 1.0.2 was used for building the multidimensional model for Python. Logistical regression analysis was executed with L1-regularization, which is an effective method for extracting the most significant features of the model.ResultsThe new system we have developed is a diagnostically meaningful set of indicators that takes into account a smaller number of criteria from the currently used Weiss scale. To validate the obtained model, we divided the initial sample set into training and test sets in a 9:1 ratio, respectively. The diagnostic algorithm is highly accurate [overall accuracy 100% (95% CI: 96%-100%)].DiscussionOur method involves determining eight diagnostically significant indicators that enable the calculation of ACC development probability using specified formulas. This approach may potentially enhance diagnostic precision and facilitate improved clinical outcomes in ACC management.

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Adrenocortical cancer: morphological variants, immunohistochemical characteristics

Cited by 8 publications

References 15 publications

Metastatic lesions of the adrenal glands. The experience of Endocrinology Research Center.

Metastatic lesions of the adrenal glands. The experience of Endocrinology Research Center.

Metastatic Adrenocortical Carcinoma With Chromothripsis: A Case Report and Literature Review

The new histological system for the diagnosis of adrenocortical cancer

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