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Oncocytic Adrenocortical Neoplasm Diagnosed after Robot-Assisted Adrenalectomy.

Harbin AC, Chen A, Bhattacharyya S, Khurana JS, Kaplan JR, Eun DD - Case Rep Urol (2015)

Bottom Line: Treatment is generally surgical, since OAN can be malignant in some cases.Differentiation between benign and malignant OAN is done based on the Lin-Weiss-Bisceglia criteria and can be difficult.If malignancy is diagnosed, recurrence is common and close surveillance should be performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Temple University Hospital, 3401 N Broad Street, Philadelphia, PA 19140, USA.

ABSTRACT
Oncocytic tumors, composed of eosinophilic, mitochondria-rich cells, can occur in several locations throughout the body. These tumors can occur in the adrenal cortex and are rarely malignant. We report a case of a patient presenting with an incidental adrenal mass which was later diagnosed as a oncocytic adrenocortical neoplasm (OAN). The patient is a 53-year-old man found to have a 7.2 cm right adrenal mass, incidentally found by computed tomography (CT). After metabolic workup was negative, a right robotic adrenalectomy (RA) was performed. Pathologic analysis revealed clusters of large cells with abundant eosinophilic and granular cytoplasm, consistent with OAN. This pathology is rare, with only about 150 cases described in the literature. It occurs in females 2.5 times more frequently and more commonly on the left side. Diagnosis is usually made by imaging criteria, typically with CT or magnetic resonance imaging (MRI). Treatment is generally surgical, since OAN can be malignant in some cases. Differentiation between benign and malignant OAN is done based on the Lin-Weiss-Bisceglia criteria and can be difficult. If malignancy is diagnosed, recurrence is common and close surveillance should be performed.

No MeSH data available.


Related in: MedlinePlus

200x magnification: the tumor is composed entirely of large cells with abundant granular eosinophilic cytoplasm and indistinct cellular boundaries. Mild nuclear atypia is seen. Mitotic figures are not evident.
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fig3: 200x magnification: the tumor is composed entirely of large cells with abundant granular eosinophilic cytoplasm and indistinct cellular boundaries. Mild nuclear atypia is seen. Mitotic figures are not evident.

Mentions: Grossly the mass was found to be a 10.5 cm, pale red-brown variegated mass with areas of hemorrhage and central scarring. Microscopic examination showed clusters of large cells with abundant eosinophilic and granular cytoplasm, consistent with an OAN. The mitotic rare was low (4 per 50 high-power fields) and no atypical mitoses were seen. It was found to invade the capsule (but not beyond) (Figures 2 and 3), and no lymphovascular invasion was identified. With these features, the tumor is best classified as a borderline OAN of uncertain malignant potential.


Oncocytic Adrenocortical Neoplasm Diagnosed after Robot-Assisted Adrenalectomy.

Harbin AC, Chen A, Bhattacharyya S, Khurana JS, Kaplan JR, Eun DD - Case Rep Urol (2015)

200x magnification: the tumor is composed entirely of large cells with abundant granular eosinophilic cytoplasm and indistinct cellular boundaries. Mild nuclear atypia is seen. Mitotic figures are not evident.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4664788&req=5

fig3: 200x magnification: the tumor is composed entirely of large cells with abundant granular eosinophilic cytoplasm and indistinct cellular boundaries. Mild nuclear atypia is seen. Mitotic figures are not evident.
Mentions: Grossly the mass was found to be a 10.5 cm, pale red-brown variegated mass with areas of hemorrhage and central scarring. Microscopic examination showed clusters of large cells with abundant eosinophilic and granular cytoplasm, consistent with an OAN. The mitotic rare was low (4 per 50 high-power fields) and no atypical mitoses were seen. It was found to invade the capsule (but not beyond) (Figures 2 and 3), and no lymphovascular invasion was identified. With these features, the tumor is best classified as a borderline OAN of uncertain malignant potential.

Bottom Line: Treatment is generally surgical, since OAN can be malignant in some cases.Differentiation between benign and malignant OAN is done based on the Lin-Weiss-Bisceglia criteria and can be difficult.If malignancy is diagnosed, recurrence is common and close surveillance should be performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Temple University Hospital, 3401 N Broad Street, Philadelphia, PA 19140, USA.

ABSTRACT
Oncocytic tumors, composed of eosinophilic, mitochondria-rich cells, can occur in several locations throughout the body. These tumors can occur in the adrenal cortex and are rarely malignant. We report a case of a patient presenting with an incidental adrenal mass which was later diagnosed as a oncocytic adrenocortical neoplasm (OAN). The patient is a 53-year-old man found to have a 7.2 cm right adrenal mass, incidentally found by computed tomography (CT). After metabolic workup was negative, a right robotic adrenalectomy (RA) was performed. Pathologic analysis revealed clusters of large cells with abundant eosinophilic and granular cytoplasm, consistent with OAN. This pathology is rare, with only about 150 cases described in the literature. It occurs in females 2.5 times more frequently and more commonly on the left side. Diagnosis is usually made by imaging criteria, typically with CT or magnetic resonance imaging (MRI). Treatment is generally surgical, since OAN can be malignant in some cases. Differentiation between benign and malignant OAN is done based on the Lin-Weiss-Bisceglia criteria and can be difficult. If malignancy is diagnosed, recurrence is common and close surveillance should be performed.

No MeSH data available.


Related in: MedlinePlus