Adrenocortical oncocytoma

Abstract

Rationale:Adrenocortical oncocytoma is an extremely rare tumor of the adrenal gland. Its diagnostic criteria and biological behavior has not yet reached a consensus. The purpose of this study is to investigate the clinical characteristics of adrenocortical oncocytoma.Patient concerns:The clinical data from 11 cases of adrenocortical oncocytoma were retrospectively analyzed. Five patients found the tumor incidentally during the healthy examination, and 3 cases found the tumor during the diagnostic work-up for the evaluation of flank pain or hypertension. A female patient manifested virilization, and Cushing's syndrome showed in two patients. The tumor diameter was ranging from 2.0-13.0 cm.Diagnoses:The serum cortisol, plasma aldosterone and catecholamine metabolites were used to evaluate the function of the tumors, and enhanced CT scan was used to confirm the tumor boundary, enhancement, and lymph nodes condition.Interventions:Seven cases underwent laparoscopic adrenal tumor resection, 4 patients underwent open surgery. Pathological report indicated adrenocortical oncocytoma in all cases, three of which were potentially malignant.Outcomes:The patients were followed up for 19-72 months, no local recurrence and distant metastases were detected in 3 cases of malignant potential cases.Lessons:The majority of adrenocortical oncocytoma with or without function are benign, and close follow-up observation is essential.

Diagnosis and Treatment of Adrenocortical Oncocytoma: Case Report of Five Cases and Review of the Literature

“…The therapy of oncocytic adrenocortical neoplasms mainly relies on the surgical resection. With the development of laparoscopic technique, the laparoscopic surgery is becoming more and more popular (17, 18). It was suggested to perform the laparotomy when the tumor size was more than 6 cm to obtain a complete resection without tumor rupture.…”

A rare combination of giant right retroperitoneal schwannoma and right adrenal oncocytoma as an incidental finding

“…Oncocytomas, on the other hand, are neoplasms made up of epithelial cells with abundant granular cytoplasm due to abnormal mitochondrial accumulation [ 3 , 5 ]. They most commonly occur in the kidney, salivary glands and thyroid gland, but have also been reported in the parathyroid, pituitary, liver, ovary and small intestine [ 3 , 5 ]. Given the rarity, with <200 cases reported in literature, the true epidemiology of adrenal oncocytomas is unknown [ 3 ].…”

“…To facilitate diagnosis, various imaging modalities are utilized. While MRI is the imaging modality of choice for schwannomas, adrenal oncocytomas have no characteristic radiological features [ 4 , 5 ]. On MRI, schwannomas possess characteristic ‘fascicular sign’, which refers to the appearance of bundles along the nerve sheath, and the ‘target sign’, caused by a hypointense center surrounded by a hyperintense periphery on T2 weighted MRI images [ 4 ].…”

“…Histologically, our patient presented with benign features and in this instance, surgical resection is the treatment of choice with no need for adjuvant treatment [ 2 , 7 ]. Schwannomas are generally treated by surgical resection while adrenal oncocytomas are treated with adrenalectomy [ 1 , 5 ].…”

ACTH-Independent Cushing’s Syndrome Associated with Left Adrenocortical Oncocytoma of Uncertain Malignant Potential

“…Indeed, the virilisation and feminization syndromes due to sexual hormone hypersecretion are well described in the literature, as well as Cushing's and Conn's syndromes due to primary hypercortisolism and hyperaldosteronism, respectively. However, adrenocortical oncocytomas generally do not have particular radiological features but large dimensions for which the diagnosis is rarely made before surgery and pathology examination [ 6 – 8 ]. We, hereby, report a case of a 27-year-old woman undergoing left laparoscopic adrenalectomy at our institution, for endogenous Cushing's syndrome, due to an adrenocortical mass, which was also an oncocytoma of uncertain malignant potential.…”