Clinical and pathomorphological “masks” of adrenocortical cancer. Difficulties of differential diagnostics by the example of own clinical observa-tions

Abstract

Difficulties in the differential diagnostics of adrenocortical cancer (ACC) are due to its heterogeneous clinical and biological behavior, which is based on a complex histogenesis and molecular genetic landscape of adrenocortical cells. In this connection, the “postulate” in the diagnosis and treatment of ACC should be a multidisciplinary approach in centers with experience in adrenal surgery and pathomorphology. The presented own clinical observations of patients with ACC diagnosed during a multiple revision of histological slides and repeated immunohistochemistry including recurrent tumor, illustrates the complexity of differential diagnosis and shows the need for further study of the subcellular mechanisms of adrenocortical oncogenesis underlying its clinical picture, morphology, and expression of valuable specific markers.

Keywords

adrenocortical cancer / differential diagnosis / pathomorphology

References

[1] Chandrasekar T., Goldberg H., Klaassen Z. et al. The who, when, and why of primary adrenal malignancies: Insights into the epidemiology of a rare clinical entity. Cancer. 2019; 125: 1050–1059.

[2] Sharma E., Dahal S., Sharma P., Bhandari A., Gupta V. et al. The Characteristics and Trends in Adrenocortical Carcinoma: A United States Population Based Study. J. Clin. Med. Res. 2018; 10: 636–640.

[3] Lloyd R.W., Osamura R., Rosay J. et al. WHO Tumor Classification Editorial Board. Endocrine and neuroendocrine tumors. Fifth edition. Lyon: MAIR 2022.

[4] Tkachuk A.V., Beltsevich D.G., Porubayeva E.E., Urusova L.S. Morphological predictors of the efficacy of mitotane therapy in adrenocortical cancer. Probl Endokrinol (Mosk) 2023; 68 (6): 76–88.

[5] Tkachuk A.V., Beltsevich D.G., Porubayeva E.E., Urusova L.S. Morphological predictors of the efficacy of mitotane therapy in adrenocortical cancer. Probl Endokrinol (Mosk). 2023; 68 (6): 76–88.

[6] Pitsava G., Maria A.G., Faucz F.R. Disorders of the adrenal cortex: Genetic and molecular aspects. Front Endocrinol (Lausanne) 2022; 29 (13): 931389.

[7] Pitsava G., Maria A.G., Faucz F.R. Disorders of the adrenal cortex: Genetic and molecular aspects. Front Endocrinol (Lausanne). 2022; 29 (13): 931389.

[8] Lam A.K. Adrenocortical Carcinoma: Updates of Clinical and Pathological Features after Renewed World Health Organisation Classification and Pathology Staging. Biomedicines. 2021; 9 (2): 175.

[9] Selivanova L.S., Abdulkhabirova F.M. etc. Oncocytic adrenocortical adrenal tumor. Pathology Archive 2015; 1: 55–59 (in Russian).

[10] Селиванова Л.С., Абдулхабирова Ф.М. и др. Онкоцитарная адренокортикальная опухоль надпочечника. Архив патологии 2015; 1: 55–59.

RIGHTS & PERMISSIONS

Eco-Vector