Oncocytic Adrenocortical Carcinoma: A Morphologic, Immunohistochemical and Ultrastructural Study of Four Cases

Abstract

Oncocytic adrenocortical neoplasms are rare, usually non-functioning tumors, found predominantly in adults. The majority of those reported have followed a benign clinical course (1-14). To date, three oncocytic adrenocortical carcinomas have been described; however, these cases emphasized only either the clinical presentation, the fine needle aspiration findings, or the ultrastructural features (2, 7, 8).We present the clinical, histologic, immunohistochemical, and ultrastructural features of four cases of oncocytic adrenocortical carcinoma. The cytopathologic findings of one case have been previously reported (7). MATERIALS AND METHODSThe consultation file of two of the authors (JA-S, AGA) and the surgical pathology files of the University of Texas Southwestern Medical Center, Dallas, and M.D. Anderson Cancer Center, Houston, Texas, were searched for oncocytic adrenocortical carcinomas. Four cases with available archival materials were identified. The cytopathologic findings of one case (case 1) have previously been published (7). Four-micrometer thick sections were cut from the formalin-fixed, paraffin-embedded blocks and stained with hematoxylin and eosin. Additional paraffin sections of selected blocks were obtained for immunohistochemical studies, which were performed on an automated immunostainer (Ventana, Biotek System, Tucson, AZ) using the standard avidin-biotin peroxidase complex technique and the heat-induced epitope retrieval buffer. The primary antibodies are listed in Table 1. For electron microscopic study, tissue of three cases was fixed in 3% glutaraldehyde, postfixed in 1% osmium tetroxide, and thin sections were stained with lead citrate

Immunohistochemical Characteristics of Adrenocortical Carcinoma: An Overview

“…5). Interestingly, Hoang et al have reported cytokeratins in 4 of 4 formalin fixed oncocytic adrenocortical carcinomas subjected to microwave retrieval prior to staining [13].…”

Adénome surrénalien à cellules oncocytaires

“…Depuis, une cinquantaine de cas ont été signalés de façon sporadique [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] . La plus grande série a été décrite par Bisceglia 1 et comprenait 10 patients.…”

“…Cette tumeur est bénigne dans la quasimajorité des cas. Néanmoins, on a signalé 5 cas d'oncocytome surrénalien malin avec invasion de la veine cave inférieure et du foie 4,6 , et 1 cas de métastase pulmonaire cas de recours à la chimiothérapie n'a été signalé dans la littérature. L'évolution était favorable dans la majorité des cas, hormis les cas métastatiques.…”

Synchronous and bilateral oncocytic carcinoma of the breast: A case report and review of the literature

“…Oncocytic cells are occasionally observed in glandular epithelia that have high metabolic activity, including that in the salivary glands, thyroid gland, kidney, parathyroid gland and pituitary gland (3)(4)(5)(6)(7)(8). However, the mechanism of oncocytic change remains to be fully elucidated; it has been reported that oncocytic change may be a type of senescent change.…”

“…Oncocytes are cells with an eosinophilic granular and reticular cytoplasm and, in the majority of cases, immunohistological analysis by light microscopy reveals that >60% of the cytoplasm is occupied by mitochondria (2). Oncocytic tumors are occasionally observed in the salivary gland, thyroid gland, kidney, parathyroid gland and pituitary gland (3)(4)(5)(6)(7)(8).…”