Comparative histologic study of 43 metastasizing and nonmetastasizing adrenocortical tumors

Publisher Website
Google Scholar
Abstract
A series of 43 [human] adrenocortical tumors was analyzed using 9 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 9 criteria was most useful in distinguishing malignant from benign tumors: nuclear grade III or IV; mitotic rate > 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 2 or less of these criteria metastasized or recurred, while all but 1 of the 19 tumors with 4 or more of these criteria either recurred or metastasized.