Table 1 Summary of clinicopathological parameters analysed and found of relevance in the diagnosis of adrenocortical carcinoma
Reference
Tang7Hough13Van Sloten14Weiss15Weiss16Evans28Harrison8Aubert9Stojadinovic11Wieneke17Tauchmanova29Assie28Bisceglia23Blanes27
Number of malignant cases analysed231642244248462467832284 – mts4 oncocytic*32
Pathological features
Non-clear cytoplasmxxx2xx(x)xxx
Diffuse architecturexxxx(x)x(x)xxx
Necrosisxxxxxxxxxxx
Nuclear atypiaxxxxx(x)x(x)xxxx
Mitotic indexxxxxxx2xxxxxxx
Atypical mitosesxxxxxxxx
Sinusoid invasionxxx(x)x(x)xx
Venous invasionxxxxx(x)xxxxx
Capsular invasionxxxxxxxxxxx
Loss normal structurex
Regressive changesx haemx haemx calcifx haem
Abnormal nucleolixxx
Nuclear hyperchromasiaxxx
Broad fibrous bandsxxx
Surgical marginsx
Extra-adrenal invasionxxx
Inflammationx
Sizexxxxx
Weightxxxxx
Myxoid changesxx (+ desmopl)
Pseudoinclusionsx
Peritumoral cortexx
Nuclear/cytoplasmic ratiox
Clinical signs
Agex
Hormonal signsxx
Weight lossx
Response to ACTHx
Urine 17-ketosteroidsx
Mts at diagnosisx
Total no. parameters(2)(12)(8)(9)(9)(7)(15)(9)(12)(16)(2)(11)(11)(11)
  • Parameters marked with x (in bold) were significantly associated with malignant behaviour or worse prognosis, or correlated with survival.

  • *An additional 4 borderline cases were analysed.

  • Mts, metastases; haem, haemorrhage; calcify, calcifications; desmopl, desmoplastic reaction.