The prognostic value of two different histopathological scoring systems for adrenocortical carcinomas

Sant, Hans Pieter van't; Bouvy, Nicole D.; Kazemier, Geert; Bonjer, H. J.; Hop, W. C. J.; Feelders, Richard A; Herder, Wouter W. de; Krijger, Ronald R. de

doi:10.1111/j.1365-2559.2007.02747.x

Cited by 48 publications

(27 citation statements)

References 32 publications

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“…A Weiss score higher than 6 was significantly associated with shortened RFS and overall survival (OS) [68] confirming earlier demonstration that the total Weiss score has prognostic value [55,69]. However, other studies did not find that Weiss score as a whole was a useful predictor for tumor recurrence after resection of the primary tumor [70][71][72].…”

Section: Proliferation Indexsupporting

confidence: 57%

Management of adrenocortical carcinoma: a consensus statement of the Italian Society of Endocrinology (SIE)

Stigliano

Chiodini

Giordano

et al. 2015

J Endocrinol Invest

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Section: Proliferation Indexsupporting

confidence: 57%

Management of adrenocortical carcinoma: a consensus statement of the Italian Society of Endocrinology (SIE)

Stigliano

Chiodini

Giordano

et al. 2015

J Endocrinol Invest

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“…Discerning malignancy in adrenocortical tumors may be difficult when invasion into surrounding tissues or metastases are missing, and algorithms of histological features have been established to help pathologists to diagnose malignancy. High mitotic rate with atypical mitoses, necrosis, high cellular pleomorphism, and capsular and vascular invasion are main histological features associated with much more aggressive tumor behavior [10,12,13]. Biphasic tumors such as sarcomatoid carcinoma and carcinosarcoma contain a sarcoma-like or sarcoma component and regroup all these aggressive histological criteria.…”

Section: Introductionmentioning

confidence: 98%

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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“…[12] сравнили модифициро-ванный индекс Weiss с индексом van Slooten у 62 больных АКР и 19 больных с аденомой коры. Индекс van Slooten оказался более чувствительным для выявления опухолей, которые в дальнейшем прогрессировали, однако время до прогрессирования достоверно коррелировало с модифи-цированным индексом Weiss.…”

Section: Discussionunclassified

Clinical assessment of histological diagnostic systems for adrenocortical tumors

Бохян¹,

Pavlovskaya²,

Gubina³

et al. 2015

Arkh. patol.

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Морфологическая диагностика адренокортикального рака (АКР) долгое время не была стандартизирована и ос-новывалась на наличии таких макроскопических призна-ков, как очаги некроза, кровоизлияния, микроскопиче-ски оценивалась клеточная атипия и митотическая актив-ность. С улучшением диагностических возможностей ко-личество выявляемых узловых образований в надпочеч-никах возросло. Соответственно участились случаи АКР небольшого размера, без специфических макроскопиче-ских признаков. Даже на микроскопическом уровне диа-гностика опухолей надпочечника нередко представляет существенные проблемы. Дифференциальная диагности-ка АКР и аденомы коры -одна из наиболее трудных за-дач в хирургической патологии [1]. Не существует какого-либо конкретного гистологического критерия (как, на-пример, инвазия капсулы или сосудов при раке щитовид- Для морфологической диагностики адренокортикального рака (АКР) наибольшее распространение получила система Weiss, включающая 9 гистологических критериев с балльной оценкой злокачественности опухоли -индекс Weiss (ИВ), а также модифицированный индекс Weiss (МИВ), оценивающий 5 наиболее информативных гистологических критериев с исключением некоторых трудных для оценки признаков. Цель исследования -сравнительный анализ эффективности ИВ и МИВ в диагностике АКР. Материал и методы. Исследовали опухоли надпочечника (АКР и аденома) от 104 больных. Проведен сравнительный анализ точности ИВ и МИВ для диагностики АКР, аденом коры надпочечника. Результаты. Для диагностики АКР чувствительность ИВ составила 96,8%, МИВ -91,5%. Разница статистически незначима (p=0,2). Заклю-чение. МИВ менее субъективен, более прост в применении и информативен для дифференциальной диагностики аденом и АКР при пограничных значениях ИВ. Однако использование МИВ для диагностики АКР без учета ИВ нецелесообразно, так как он чаще, чем ИВ, не достигает порогового значения (3 балла) при злокачественных опухолях. Ключевые слова: адренокортикальный рак, аденома коры надпочечника, индекс Weiss, модифицированный индекс Weiss.The Weiss scoring system encompassing 9 histological criteria for tumor grading the Weiss index (WI) and modified Weiss index (MWI), which evaluate the 5 most informative histological criteria with the exception of some inestimable signs has gained the widest acceptance for the morphological diagnosis of adrenocortical carcinoma (ACC). Objective: to comparatively analyze the efficiency of WI and MWI in the diagnosis of ACC. Subjects and methods. Adrenal tumors (ACC and adenoma) from 104 patients were studied. The accuracy of WI and MWI for the diagnosis of ACC and adrenocortical adenomas was comparatively analyzed. Results. The sensitivities of WI and MWI for the diagnosis of ACC were 96.8 and 91.5%, respectively. The difference was statistically insignificant (p=0.2). Conclusion. MWI is less subjective, easier-to-use, and more informative for the differential diagnosis of adenomas and ACC at borderline WI values. However, there is little point in using MWI to diagnose without considering WI as MWI unreached the thre...

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The prognostic value of two different histopathological scoring systems for adrenocortical carcinomas

Abstract: The VSI and the WRI have equal validity in the correct categorization of ACC and adenomas. Furthermore, both indices show a correlation with survival for metastasizing ACC.

Cited by 48 publications

References 32 publications

Management of adrenocortical carcinoma: a consensus statement of the Italian Society of Endocrinology (SIE)

Management of adrenocortical carcinoma: a consensus statement of the Italian Society of Endocrinology (SIE)

Primary adrenocortical sarcomatoid carcinoma: case report and review of literature

Clinical assessment of histological diagnostic systems for adrenocortical tumors

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