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Case 310 - Discussion

Uploaded: 2009-08-25, Updated: 2009-08-15

Diagnosis: adrenal cortical carcinoma

Discussion:

  • Rare tumor, 1/1M; 40-50 years.

  • Common complain, abdominal or flank pain.

  • Can cause Cushing's syndrome, virilization. Malignant tumors are more often non-functional.

  • 500-1300 grams, average size 15 cm.

  • Gross: may be encapsulated and lobulated; cut surface, nodular, yellow-orange to tan, often necrosis and hemorrhage.

  • Micro:

    • Various patterns. Most common pattern: broad anastomosing trabeculae surrounded by sinusoids. Other patterns: alveolar, solid, diffuse. Other findings: spindle foci, myxoid or mucinous stroma.

    • Cytoplasm: abundant, granular, eosinophilic or clear.

    • Mitoses, maybe numerous and atypical.

  • Diagnostic features: vascular invasion, capsular invasion, and extension into the adipose tissue.

  • IPX: vimentin +, inhibin +, CK-