Adrenal carcinosarcoma--a case report

Lee, Mi-Sook; Park, In-Ae; Chi, Je-G.; Ham, Eui Keun; Lee, Kyeong-Cheol; Lee, Chongwook

doi:10.3346/jkms.1997.12.4.374

Cited by 28 publications

(24 citation statements)

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“…This adrenocortical carcinoma variant is extremely rare, and to our knowledge, only nine cases have been reported in the literature so far [3,8,9,10,16,24,30,33,38]. This tumor type is aggressive, and the recognition of diagnostic features of malignancy is not problematic.…”

Section: Sarcomatoid Carcinomamentioning

confidence: 99%

The Weiss Score and Beyond—Histopathology for Adrenocortical Carcinoma

et al. 2011

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The pathological diagnosis of adrenocortical carcinoma (ACC) is still challenging for its rarity and the presence of special variants (pediatric, oncocytic, myxoid, and sarcomatoid). It is based on the recognition at light microscopy of at least three among nine morphological parameters, according to the Weiss scoring system, which has been introduced 27 years ago and nowadays is the most widely employed. Nevertheless, the diagnostic performance of this system is very high but does not reach a sensitivity and specificity of 100%, its diagnostic applicability is potentially low among non-expert pathologists, and a group of borderline cases with only one or two criteria exist of uncertain behavior. Moreover, it is scarcely reproducible in the ACC morphological variants. In fact, specifically for the pure oncocytic neoplasms that seem to have a better prognosis in comparison to the conventional ACCs, a modified system (the Lin-Weiss-Bisceglia) has been proposed. With the aim to simplify the ACC diagnosis, 2 years ago, the "reticulin" diagnostic algorithm has been proposed, based on the observation that the tumoral reticulin framework (highlighted by reticulin silver-based histochemical staining) is consistently disrupted in malignant cases but only in a small subset of benign cases. Following this algorithm, in the presence of reticulin alterations, malignancy is further defined through the identification of at least one of the following parameters: necrosis, high mitotic rate, and venous invasion. As a complement to the morphological approach, some immunohistochemical markers (such as steroidogenic factor 1) have been proposed as diagnostic and prognostic adjuncts but still lack wide clinical validation.

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Section: Sarcomatoid Carcinomamentioning

confidence: 99%

The Weiss Score and Beyond—Histopathology for Adrenocortical Carcinoma

et al. 2011

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“…The first report of primary adrenal sarcomatoid carcinoma was in 1989 by Collina et al (6). At the time of writing the present study, to the best of our knowledge only 11 cases had previously been reported (6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The majority of those patients succumbed to disease within a year, due to local recurrence or de novo metastases.…”

Section: Introductionmentioning

confidence: 59%

“…Data collected from the present patient, as well as from the previous 11 reported cases identified in the literature, revealed that the patient age range at the time of presentation with adrenal sarcomatoid carcinoma was 29-79 years, with a mean age of 55.75 years (6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The female:male ratio in this small sample size was 1:1.…”

Section: Discussionmentioning

confidence: 87%

“…To the best of our knowledge, the present case report describes the 12th reported case of primary adrenal sarcomatoid carcinoma and reviews the previous literature (Table I) (6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Data collected from the present patient, as well as from the previous 11 reported cases identified in the literature, revealed that the patient age range at the time of presentation with adrenal sarcomatoid carcinoma was 29-79 years, with a mean age of 55.75 years (6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 95%

“…Abdominal palpation revealed no masses. Aldosterone (56.38 pg/ml; normal, 23.50-106.60 pg/ml) and cortisol (8 AM, 13.96 µg/dl; normal, 7.20-18.20 µg/dl; 4 AM, 6.61 µg/dl; normal, 2.75-6.65 µg/dl; 12 AM, 0.96 µg/dl; normal, 0.00-1.54 µg/dl) levels were within the normal limits. Initial blood tests revealed low hemoglobin levels (71 g/l; normal, 120-160 g/l).…”

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Primary adrenal sarcomatoid carcinoma metastatic to the lung: Case report and review of the literature

Zhu¹,

Zheng²,

Mao³

et al. 2016

Oncology Letters

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Abstract. Adrenal sarcomatoid carcinoma is a rare adrenal carcinoma. To the best of our knowledge, only 11 cases have been reported since 1987. Adrenal sarcomatoid carcinoma presents a diagnostic challenge due to its atypical symptoms and histological patterns. At the time of diagnosis, a large percentage of patients are already at the metastatic stage and succumb within a few months. The present study reports a case of a 59-year-old man presenting with asthenia and weight loss with adrenal sarcomatoid carcinoma metastatic to the lung. A computed tomography (CT) scan and ultrasonography of the patient's abdomen suggested a large homogeneous mass in the right adrenal gland, and a CT scan of his chest suggested lung metastasis. Right adrenalectomy was performed. Histological examination revealed that the tumor was composed of sarcomatous and carcinomatous differentiation elements. Immunohistochemical examination revealed tumor cell positivity for vimentin and cytokeratin. At the 6-month follow-up the patient exhibited no disease progression and refused further proposed treatment. The patient was alive at the time of writing the current report. The present case report additionally reviews the literature, for the purpose of raising awareness of these rare lesions and assisting in achieving accurate diagnoses and effective treatment.

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Primary adrenocortical sarcomatoid carcinoma: case report and review of literature

et al. 2007

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Adrenocortical carcinoma (AC) mixed with a sarcoma or sarcoma-like component is exceptional, and only six cases have been detailed in the literature, three including osteo-, chondro-, or rhabdomyosarcoma components, and three others only showing a malignant spindle cell component. These histological subtypes, respectively called adrenal carcinosarcomas and sarcomatoid AC, represent poorly differentiated and extremely aggressive forms of carcinoma, with locoregional recurrence and metastases rapidly arising from the sarcomatous or sarcomatoid component, and death occurring in a few months. We report a case of AC in a 31-year-old man presenting as a nonfunctional tumor, with a histological biphasic pattern combining few areas of differentiated AC and extensive areas of sarcomatoid spindle cell proliferation. The patient died 3 months of locoregional and distant recurrences after surgery despite apparently total tumor resection and VP16-cisplatinum chemotherapy. This case underlines the necessity to identify and isolate these carcinoma's subtypes with worse prognosis and the difficulties to distinguish them from metastatic carcinomas and retroperitoneal sarcomas, in relation to the particular adrenal cortex immunoprofile. According to the World Health Organization principles of terminology, we suggest these tumors be collectively classified as "adrenal sarcomatoid carcinomas," a designation that tends to unify all carcinomas with "pleomorphic, sarcomatoid, or sarcomatous elements."

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Adrenal carcinosarcoma--a case report

Cited by 28 publications

References 0 publications

The Weiss Score and Beyond—Histopathology for Adrenocortical Carcinoma

The Weiss Score and Beyond—Histopathology for Adrenocortical Carcinoma

Primary adrenal sarcomatoid carcinoma metastatic to the lung: Case report and review of the literature

Primary adrenocortical sarcomatoid carcinoma: case report and review of literature

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