Images in Endocrine Pathology: Unique Composite Adrenal Adenomatoid Tumor, Ganglioneuroma, Myelolipoma, and Cortical Nodular Hyperplasia

Duregon, Eleonora; Volante, Marco; Guzzetti, Stefano; Rapa, Ida; Vatrano, Simona; Papotti, Mauro

doi:10.1007/s12022-017-9480-9

Cited by 3 publications

(4 citation statements)

References 12 publications

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“…Depending on the anatomic site its name differs: pleura (lining the lungs and chest wall), peritoneum (lining the abdominal organs and wall), pericardium (lining the heart) and tunica vaginalis (lining the testes). Adenomatoid tumors usually occur in the genital tract of both sexes and less frequently in heart, 2 mediastinum, 3‐5 pancreas, 6 liver, 7‐12 pleura, 13 mesocolon, 14 omentum, 14‐16 lymph node, 17 peritoneum, 9,18 intestinal mesentery, 19 adrenal glands, 20‐55 and skin 56 . Most tumors are discovered incidentally.…”

Section: Discussionmentioning

confidence: 99%

Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque

et al. 2020

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Adenomatoid tumors are benign tumors of mesothelial origin that are usually encountered in the genital tract. Although they have been observed in other organs, the skin appears to be a very rare location, with only one case reported in the literature to our knowledge. We report a second case of an adenomatoid tumor, arising in the umbilicus of a 44-year-old woman. The patient presented with an 8-month-old erythematous and firm plaque under the umbilicus. A skin biopsy showed numerous microcystic spaces dissecting a fibrous stroma and lined by flattened to cuboidal cells with focal intraluminal papillary formation. This little-known diagnosis constitutes a diagnostic pitfall for dermatopathologists and dermatologists, and could be misdiagnosed as other benign or malignant entities. Through this case report, a practical approach and diagnostic keys have been devised to avoid misdiagnosis and overtreatment.

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Section: Discussionmentioning

confidence: 99%

Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque

et al. 2020

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“…However, apart from the macroscopic invasion of nearby structures, no single histopathologic trait indicates malignancy per se. Cases of misleading adrenal cortical masses (eg, rare variants and subtypes, see below) or contrasting features (eg, small and localized lesions with malignant histopathologic features and large tumors with bland-looking neoplastic cells) may occur, leading to significant diagnostic pitfalls and ultimately making ACC a challenging diagnosis even for expert pathologists 12,25,28,32,37,42,51,53,55,68,69. To facilitate and standardize ACC diagnosis, several multiparametric scoring systems based on combined histopathologic features have been developed and tested and are now part of the routine diagnostic workup.…”

Section: Nomenclature and Diagnostic Categories Of Adrenal Cortical T...mentioning

confidence: 99%

“…1). [5][6][7][8][9][10][11][12] Focusing on adrenal cortical tumors (ACTs), the primary diagnostic concern is the accurate and precocious assessment of the malignant potential of the lesion to guide subsequent therapeutic management and follow-up. 13 Unfortunately, ACC can present clinical, laboratory, and imaging features overlapping with other primary or secondary malignant lesions and with benign conditions.…”

Section: Nomenclature and Diagnostic Categories Of Adrenal Cortical T...mentioning

confidence: 99%

Histopathologic Features of Adrenal Cortical Carcinoma

Gambella¹,

Volante

Papotti

2022

Advances in Anatomic Pathology

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Adrenal cortical carcinoma (ACC) is a rare and aggressive malignancy that poses challenging issues regarding the diagnostic workup. Indeed, no presurgical technique or clinical parameters can reliably distinguish between adrenal cortical adenomas, which are more frequent and have a favorable outcome, and ACC, and the final diagnosis largely relies on histopathologic analysis of the surgical specimen. However, even the pathologic assessment of malignancy in an adrenal cortical lesion is not straightforward and requires a combined evaluation of multiple histopathologic features. Starting from the Weiss score, which was developed in 1984, several histopathologic scoring systems have been designed to tackle the difficulties of ACC diagnosis. Dealing with specific histopathologic variants (eg, Liss-Weiss-Bisceglia scoring system for oncocytic ACC) or patient characteristics (eg, Wieneke index in the pediatric setting), these scores remarkably improved the diagnostic workup of ACC and its subtypes. Nevertheless, cases with misleading features or discordant correlations between pathologic findings and clinical behavior still occur. Owing to multicentric collaborative studies integrating morphologic features with ancillary immunohistochemical markers and molecular analysis, ACC has eventually emerged as a multifaceted, heterogenous malignancy, and, while innovative and promising approaches are currently being tested, the future clinical management of patients with ACC will mainly rely on personalized medicine and target-therapy protocols. At the dawn of the new Fifth World Health Organization classification of endocrine tumors, this review will tackle ACC from the pathologist's perspective, thus focusing on the main available diagnostic, prognostic, and predictive tissue-tethered features and biomarkers and providing relevant clinical and molecular correlates.

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“…Tumors previously reported to develop in association with myelolipoma include hematolymphoid neoplasms, adrenocortical adenoma/carcinoma, adenomatoid tumor, ganglioneuroma, pheochromocytoma, germ cell tumor, and renal cell carcinoma. [6][7][8][9] There are also reports of myelodysplastic syndrome and Castleman disease associated with myelolipoma. 10 Herein, we report the first case of a composite tumor composed of a malignant vascular neoplasm-EHE-that arose within an extra-adrenal myelolipoma (EAM).…”

Section: Introductionmentioning

confidence: 99%

Epithelioid Hemangioendothelioma Arising Within Mediastinal Myelolipoma: A WWTR1-Driven Composite Neoplasm

et al. 2019

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In this article, we describe a case of conventional epithelioid hemangioendothelioma (EHE) arising within an extra-adrenal myelolipoma. This composite neoplasm arose in the mediastinum of a 51-year-old female. The tumor was composed of a large myelolipoma that contained nodules of EHE consisting of CD31-positive epithelioid endothelial cells that grew in solid cords and were enmeshed in a basophilic hyalinized stroma. Both EHE and myelolipoma are characterized genetically by alterations of WWTR1. We demonstrated the expression of CAMTA-1 chimeric protein by immunohistochemistry both in the neoplastic endothelial cells of EHE and some of the endothelial cells lining the blood vessels in the myelolipoma. To the best of our knowledge, this is the first report of a malignant vascular neoplasm arising in association with myelolipoma.

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Images in Endocrine Pathology: Unique Composite Adrenal Adenomatoid Tumor, Ganglioneuroma, Myelolipoma, and Cortical Nodular Hyperplasia

Cited by 3 publications

References 12 publications

Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque

Adenomatoid tumor of the skin: Differential diagnosis of an umbilical erythematous plaque

Histopathologic Features of Adrenal Cortical Carcinoma

Epithelioid Hemangioendothelioma Arising Within Mediastinal Myelolipoma: A WWTR1-Driven Composite Neoplasm

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