کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4132685 1271391 2015 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Pitfalls in the diagnosis of adrenocortical tumors: a lesson from 300 consultation cases
ترجمه فارسی عنوان
مشکلات در تشخیص تومورهای آدرنوکورتیک: یک درس از 300 مورد مشاوره
کلمات کلیدی
کارسینوم آدرنوکورتیک، غده فوق کلیوی، تشخیص های افتراقی، مشاوره آسیب شناسی فئوکروموسیتوم
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی آسیب‌شناسی و فناوری پزشکی
چکیده انگلیسی

SummaryThe correct pathologic classification of adrenocortical carcinoma (ACC) is relevant to establish an early therapeutic strategy of this rare malignancy. The aim of the study was to assess the most frequent pitfalls in ACC diagnosis reviewing a large consecutive series of 300 cases with an original diagnosis or a clinical suspect of ACC, which were sent in consultation to our institution between 2004 and 2014. A major disagreement that significantly modified the clinical management of patients was recorded in 26 cases (9%). The most common pitfall (10 cases) was to distinguish ACC from pheochromocytoma and vice versa. Seven other cases diagnosed as ACC were reclassified as metastases from other primaries and primary adrenal soft tissue tumors (including 3 angiosarcomas). Finally, 5 adrenocortical adenomas were reclassified into carcinomas, and 4 ACCs were converted into adenomas. Minor disagreements were mostly related to the identification of ACC variants (up to 32% of cases of adrenocortical tumors in the present series). Moreover, more than 50% of ACC cases lacked Ki-67. In conclusion, our results indicate that, in the presence of a histologically suspected ACC, a special attention should be devoted to exclude metastatic and soft tissue tumors and pheochromocytoma (in this latter case with special reference to the oncocytic variant of adrenocortical tumors). Moreover, pathologists should be aware of the major role of Ki-67 in determining prognosis and in selecting patients to the most appropriate treatment.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Human Pathology - Volume 46, Issue 12, December 2015, Pages 1799–1807
نویسندگان
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