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      Adrenocortical oncocytoma : 11 Case reports and review of the literature

      case-report

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          Abstract

          Rationale:

          Adrenocortical oncocytoma is an extremely rare tumor of the adrenal gland. Its diagnostic criteria and biological behavior has not yet reached a consensus. The purpose of this study is to investigate the clinical characteristics of adrenocortical oncocytoma.

          Patient concerns:

          The clinical data from 11 cases of adrenocortical oncocytoma were retrospectively analyzed. Five patients found the tumor incidentally during the healthy examination, and 3 cases found the tumor during the diagnostic work-up for the evaluation of flank pain or hypertension. A female patient manifested virilization, and Cushing's syndrome showed in two patients. The tumor diameter was ranging from 2.0-13.0 cm.

          Diagnoses:

          The serum cortisol, plasma aldosterone and catecholamine metabolites were used to evaluate the function of the tumors, and enhanced CT scan was used to confirm the tumor boundary, enhancement, and lymph nodes condition.

          Interventions:

          Seven cases underwent laparoscopic adrenal tumor resection, 4 patients underwent open surgery. Pathological report indicated adrenocortical oncocytoma in all cases, three of which were potentially malignant.

          Outcomes:

          The patients were followed up for 19-72 months, no local recurrence and distant metastases were detected in 3 cases of malignant potential cases.

          Lessons:

          The majority of adrenocortical oncocytoma with or without function are benign, and close follow-up observation is essential.

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          Most cited references15

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          Comparative histologic study of 43 metastasizing and nonmetastasizing adrenocortical tumors.

          A series of 43 adrenocortical tumors was analyzed using nine histologic features. Mitotic activity, especially with atypical forms, and venous invasion correlated best with metastasizing or recurring tumors; however, no single criterion was useful alone. The combination of the following nine criteria was most useful in distinguishing malignant from benign tumors: nuclear grade III or IV; mitotic rate greater than 5/50 high-power fields; atypical mitoses; clear cells comprising 25% or less of the tumor; a diffuse architecture; microscopic necrosis; and invasion of venous, sinusoidal, and capsular structures. None of the 24 tumors with two or less of these criteria metastasized or recurred, while all but one of the 19 tumors with four or more of these criteria either recurred or metastasized.
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            Adrenal oncocytic neoplasm: a systematic review.

            Oncocytic neoplasms as tumors arising in the adrenal glands are rare, usually considered as nonfunctional and benign. In the current literature, there are extremely limited reports of adrenal oncocytic neoplasms; as to date, only 147 cases have been described. The rarity of the event prompted this study which reviews and presents the incidence, histology, diagnosis and therapy of adrenal oncocytic neoplasms.
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              Adrenal oncocytoma: US and CT findings.

              We describe a case of an oncocytoma occurring in the adrenal gland, a rare location, and describe US and CT findings of this tumor in our patient. The mass was well marginated but heterogeneous on both CT and US and unfortunately the imaging findings of the tumor are non-specific.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                December 2017
                01 December 2017
                : 96
                : 48
                : e8750
                Affiliations
                [a ]Department of Urology
                [b ]Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun Jilin, P.R. China.
                Author notes
                []Correspondence: Xiaoqing Wang, Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, P.R. China (e-mail: upw018@ 123456126.com ); Hongli Shan, Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, Jilin, P. R. China (e-mail: shanhonglili@ 123456163.com ).
                Article
                MD-D-17-05567 08750
                10.1097/MD.0000000000008750
                5728750
                29310349
                ad65ef2a-51e0-48ad-bd53-0ee4c36df48b
                Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                : 6 September 2017
                : 12 October 2017
                : 16 October 2017
                Categories
                5700
                Research Article
                Clinical Case Report
                Custom metadata
                TRUE

                adrenal tumor,adrenocortical oncocytoma,malignant potential,treatment

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