Metastatic adrenocortical oncocytoma: A case report

Imaging appearance of bulk fat within an oncocytic adrenocortical neoplasm, a rare and potentially malignant tumour

“…In such cases, the lesion has been designated by some authors as an adrenocortical oncocytoma [4,5,9,11], analogous to the oncocytoma that is recognised in the kidney and salivary, thyroid and parathyroid glands [7]. However, oncocytic adrenocortical neoplasms have also presented in some cases as carcinomas with a malignant clinical course; for example, demonstrating invasion of the inferior vena cava [8,[12][13][14], local recurrence following resection [15,16] and bone, liver and lung metastases [15], with death as a reported outcome [17]. Thus, the major challenge in the management of these neoplasms is to distinguish benign from malignant lesions.…”

“…Yet, the entity remains incompletely understood, with no single clinical, histological or immunochemical feature able to predict the clinical course of an individual lesion. To assist in their categorisation, Bisceglia et al [17] proposed a classification system that divided oncocytic adrenocortical neoplasms into three broad groups on the basis of histological features with different prognostic implications; however, given the small number of lesions reported, as well as the short clinical follow-up available for most lesions, this classification system is considered controversial [15] and caution is still warranted when applying histological criteria to individual lesions [17]. Indeed, some reported cases in the literature have demonstrated a more aggressive clinical course than would be predicted using this classification system [8,12,13,17].…”

“…Krishnamurthy et al [8] diagnosed an indeterminate adrenal lesion as an oncocytic adrenocortical neoplasm using fine-needle aspiration (FNA), noting that oncocytic cells had a characteristic appearance that was easily recognised in the FNA smear and allowed for a definite diagnosis to be made using this technique. Although FNA might correctly diagnose an indeterminate adrenal lesion as an oncocytic adrenocortical neoplasm, the diagnosis will not alter the need for surgical management [4,15]; it is not possible to assess for capsular or vascular invasion based on cytology alone and focal areas of abnormal mitotic activity or necrosis might be missed owing to sampling error [17]. The difficulty of attempting to classify oncocytic adrenal neoplasms on the basis of a limited tissue sample is demonstrated by a case reported in the literature in which recurrent neoplastic disease resulted in death.…”

Adénome surrénalien à cellules oncocytaires

“…Depuis, une cinquantaine de cas ont été signalés de façon sporadique [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] . La plus grande série a été décrite par Bisceglia 1 et comprenait 10 patients.…”

Retroperitoneal oncocytoma: case report and review of the imaging features

“…Oncocytomas have rarely been reported in a number of distinct anatomical locations including the kidney, lung, breast, ovary, liver, gut, prostate gland and various sites in the head and neck including the pituitary, thyroid and salivary glands [2,3]. When present in the retroperitoneum, such lesions arise from either the kidney or the adrenal gland [4].…”