Molecular pathology of adrenal cortical tumors: separating adenomas from carcinomas

Adrenal cortical carcinoma is a rare but interesting endocrine tumor. Its diagnosis is usually straightforward using morphologic assessment and supplemental immunohistochemistry. However, diagnostically challenging cases exist and pathologic evaluation would benefit from the availability of adjunctive molecular testing. Here, the relevant molecular pathology of adrenal cortical tumors is reviewed with special reference to those methods (e.g., DNA microarrays) that hold promise for improved diagnosis and prognosis, and prediction of therapeutic response.