Oncocytic Adrenal Neoplasms: Clinical Profiles and Long-Term Outcomes

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Ococytic adrenal neoplasms, characterized by ≥90% oncocytic cells, are uncommon.
• The clinical significance of oncocytic changes in adrenal neoplasms is not well-defined.

Purpose of the Study:

• To evaluate the clinical behavior and outcomes of pure oncocytic adrenal neoplasms.
• To determine the malignant potential and recurrence rates of these rare tumors.

Main Methods:

• Retrospective analysis of 33 adult patients who underwent adrenalectomy for pure oncocytic neoplasms (1997-2022).
• Neoplasms classified using the Lin-Weiss-Bisceglia system (benign, malignant, uncertain potential).
• Statistical analysis included Fisher exact, Kruskal-Wallis, and Kaplan-Meier methods; Ki67 proliferation index assessed.

Main Results:

• 24% benign, 36% malignant, 39% uncertain malignant potential.
• No recurrences in benign neoplasms; 50% recurrence in malignant neoplasms.
• Neoplasms of uncertain potential recurred as metastatic adrenocortical carcinoma; higher Ki67% correlated with recurrence.

Conclusions:

• Ococytic adrenal neoplasms, though rare, have a significant risk of malignancy or malignant potential.
• Close follow-up is essential for oncocytic adrenal neoplasms of uncertain malignant potential due to recurrence risk.
• Ki67 index is a valuable predictor of recurrence in these neoplasms and should be routinely obtained.