Abstract
BackgroundAdrenal cortex oncocytic carcinoma (AOC) represents an exceptional pathological entity, since only 22 cases have been documented in the literature so far.Case presentationOur case concerns a 54-year-old man with past medical history of right adrenal excision with partial hepatectomy, due to an adrenocortical carcinoma. The patient was admitted in our hospital to undergo surgical resection of a left lung mass newly detected on chest Computed Tomography scan. The histological and immunohistochemical study revealed a metastatic AOC. Although the patient was given mitotane orally in adjuvant basis, he experienced relapse with multiple metastases in the thorax twice in the next year and was treated with consecutive resections. Two and a half years later, a right hip joint metastasis was found and concurrent chemoradiation was given. Finally, approximately five years post disease onset, the patient died due to massive metastatic disease. A thorough review of AOC and particularly all diagnostic difficulties are extensively stated.ConclusionHistological classification of adrenocortical oncocytic tumours has been so far a matter of debate. There is no officially established histological scoring system regarding these rare neoplasms and therefore many diagnostic difficulties occur for pathologists.
Highlights
Adrenal cortex oncocytic carcinoma (AOC) represents an exceptional pathological entity, since only 22 cases have been documented in the literature so far.Case presentation: Our case concerns a 54-year-old man with past medical history of right adrenal excision with partial hepatectomy, due to an adrenocortical carcinoma
Electron microscopic studies revealed that this granularity was due to mitochondria accumulation in the oncocyte cytoplasm [2]
A 54-year-old man was admitted in the Thoracic and Vascular Surgery Department of our hospital with a 2 cm mass at the upper lobe of the left lung detected on Computed Tomography (CT) scan to undergo complete surgical resection
Summary
Histological classification of adrenocortical oncocytic tumours has been so far a matter of debate. There is no officially established histological scoring system regarding these rare neoplasms and many diagnostic difficulties occur for pathologists. Metastatic disease is the only definite criterion of malignancy. Molecular biology and large clinical studies may probably provide in the future more precise criteria for the classification, clinical behaviour and therapeutic approach of AOCs. AC: Adrenocortical Carcinoma; AO: Adrenocortical Oncocytoma; AOC: Adrenocortical Oncocytic Carcinoma; AON: Adrenocortical Oncocytic Neoplasm; AONUMP: Adrenocortical Oncocytic Neoplasm of Uncertain Malignant Potential; CT scan: Computed Tomography scan; HPF: High Power Field. Written informed consent was obtained from the patient's relatives for publication of this case report and the accompanying images. A copy of the written consent is available for review by the Editor- in-Chief of this journal
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