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Review
. 2023 Nov 4;12(21):6925.
doi: 10.3390/jcm12216925.

Prognosis of Adrenal Oncocytic Neoplasms (AONs): Literature Review of 287 Cases and Presentation of the Oldest Patient

Enrico Coppola Bottazzi  1 , Claudio Gambardella  2 , Federico Maria Mongardini  2 , Serafino Vanella  1 , Adele Noviello  1 , Tommaso Palma  1 , Rosa Murano  1 , Giovanni De Chiara  3 , Giovanni Conzo  2 , Ludovico Docimo  2 , Francesco Crafa  1
Affiliations
Review

Prognosis of Adrenal Oncocytic Neoplasms (AONs): Literature Review of 287 Cases and Presentation of the Oldest Patient

Enrico Coppola Bottazzi et al. J Clin Med. .

Abstract

Introduction: The adrenocortical oncocytic neoplasms (AONs) are rare tumors of the adrenal gland, classified as oncocytoma (AO), oncocytic neoplasm of uncertain malignant potential (AONUMP) and oncocytic carcinoma (AOC). The aim of this study was to perform a review of the literature, in order to evaluate the prognosis of these rare cancers. We also reported the oldest patient with AON.

Methods: A comprehensive literature review using as key words "adrenal oncocytoma", "adrenal oncocytic neoplasm", and "adrenal oncocytic carcinoma" was performed.

Report of the case: We report the case of an 88-year-old woman receiving a left open adrenalectomy for an AON (15 × 10 × 8 cm). The considerable size and weight together with the presence of necrosis were indicative for a lesion with an uncertain potential for malignancy, according to Weiss modified criteria. After two years, the patient was free from any sign of recurrence.

Results: Only 287 AONs were detected in the scientific literature, exploring OVID, MEDLINE, PubMed and SCOPUS as dataset. These tumors are usually incidentalomas with an unpredictable malignant potential. Surgical resection remains the mainstay of treatment for AON.

Conclusion: AO and AONUMP have an excellent prognosis and a low mortality rate, with only three cases of recurrence reported in the literature and one metastatic case four years after first adrenal surgery. In contrast, AOC carries a high risk of local relapses, distant metastasis, and a significantly higher mortality rate (30%). Surgical resection remains the primary treatment for adrenal oncocytic neoplasms.

Keywords: adrenal oncocytic carcinoma; adrenal oncocytic neoplasms; adrenal oncocytoma; oncocytic neoplasm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
CT-scan image: left adrenal mass capsulated and not homogeneous, displacing the pancreatic body and the splenic vessels anteriorly and the kidney and renal vessels inferiorly. The red arrow indicates the splenic artery displaced by the mass, the yellow arrow indicates the left renal vessels, the asterisk indicates the adrenal mass.
Figure 2
Figure 2
Macroscopically: (A,B) adrenal tumor mass (17 × 13 cm); (C) cut surface of the mass, homogeneous, well encapsulated and with central area of necrosis. Microscopically: (D) oncocytoma with abundant granular eosinophilic cytoplasm (magnification 60×); (E) an intact capsule (magnification 4×); (F) necrosis areas (magnification 20×).
Figure 3
Figure 3
Immunohistochemistry study revealed: positivity for melan-A, inhibin, cytokeratins AE1-AE3, cytokeratin 8/18, synaptophysin, and calretinin; negativity for vimentin and S100 and Ki67/MIB1 proliferative activity of 20%. (Magnification 40×).
See this image and copyright information in PMC

References

    1. Hamperl H. Oncocytes and the so-called hurthle cell tumor. Arch. Pathol. 1950;49:563–570.
    1. Jaffe R.H. Adenolymphoma [oncocytoma] of parotid gland. Am. J. Cancer. 1932;16:1415–1423.
    1. Saygin I., Cakir E., Ercin M.E., Eyüboğlu I. Incidental retroperitoneal oncocytoma (Ectopic oncocytic adrenocortical adenoma): Case report and review of the literature. Indian J. Pathol. Microbiol. 2019;62:132–135. doi: 10.4103/IJPM.IJPM_58_18. - DOI - PubMed
    1. Fadare O., Ma L., Kowalski D. Pathologic quiz case: A 55-yearold woman with an adrenal mass. Arch. Pathol. Lab. Med. 2003;127:e167–e168. doi: 10.5858/2003-127-e167-PQCAYW. - DOI - PubMed
    1. Kakimoto S., Yushita Y., Sanefuji T., Kondo A., Fujishima N., Kishikawa M., Matsumoto K. Non-hormonal adrenocortical adenoma with oncocytoma-like appearances. Hinyokika Kiyo. 1986;32:757–763. - PubMed