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Oncocytic adrenal cortical adenoma
1Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Ultrastructural Pathology
|July 1, 1991
Summary
A rare virilizing oncocytic adrenal cortical adenoma was identified in a patient with a history of bladder cancer. This unique adrenal tumor shows a good prognosis after surgical removal.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- A 61-year-old woman with a history of papillary transitional cell carcinoma of the urinary bladder presented with a newly discovered left adrenal gland mass.
- Adrenal gland tumors require careful evaluation due to their potential for hormonal activity and malignancy.
Observation:
- Clinicopathologic and ultrastructural examination revealed a 5-cm virilizing oncocytic adrenal cortical adenoma, a previously undocumented subtype.
- The tumor cytoplasm was densely packed with mitochondria exhibiting tubulovesicular cristae, alongside well-developed smooth endoplasmic reticulum and Golgi apparatus.
- Immunohistochemical analysis showed variable reactivity for cytokeratins and weak synaptophysin staining in a subset of tumor cells.
Findings:
- The oncocytic adrenal cortical adenoma demonstrated features indicative of a benign nature, including small size, low mitotic rate, and absence of necrosis or invasion.
- Electron microscopy revealed abundant mitochondria with unique cristae, suggesting a specific metabolic or functional characteristic.
- Discussion includes two additional cases of oncocytic adrenocortical tumors, highlighting the rarity of this neoplasm.
Implications:
- The favorable clinicopathologic features suggest a good prognosis for this rare oncocytic adrenal cortical neoplasm.
- The patient remains disease-free one year post-surgery, supporting the benign nature of the tumor.
- Further case studies and extended follow-up are necessary to fully elucidate the behavior and clinical management of oncocytic adrenal cortical adenomas.