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Comparative histologic study of 43 metastasizing and nonmetastasizing adrenocortical tumors
Abstract
A series of 43 adrenocortical tumors was analyzed using nine histologic features. Mitotic activity, especially with atypical forms, and venous invasion correlated best with metastasizing or recurring tumors; however, no single criterion was useful alone. The combination of the following nine criteria was most useful in distinguishing malignant from benign tumors: nuclear grade III or IV; mitotic rate greater than 5/50 high-power fields; atypical mitoses; clear cells comprising 25% or less of the tumor; a diffuse architecture; microscopic necrosis; and invasion of venous, sinusoidal, and capsular structures. None of the 24 tumors with two or less of these criteria metastasized or recurred, while all but one of the 19 tumors with four or more of these criteria either recurred or metastasized.
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“In the initial study by Weiss, the features with the strongest association to outcome were the mitotic rate >5/50 high powered field, atypical mitoses, and venous invasion (111) and in the second study by Weiss in 1989 the strongest association with patient outcome was the mitotic rate (112).”
From Adrenal incidentaloma (2020) · cites this paper as [111]
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“The most widely used histological scoring system is the Weiss score (Table 4) based on 9 histological parameters (scored as 0 if absent and 1 if present) (110,111).”
From Adrenal incidentaloma (2020) · cites this paper as [111]
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Metadata
- Authors
- Weiss, L. M.
- Corresponding author
- Weiss, Lawrence M.
- ORCID
- Weiss, Lawrence M.
- Venue
- The American Journal of Surgical Pathology
- Published
- 1984-03
- Volume
- 8
- Issue
- 3
- Pages
- 163-170
- ISSN
- 0147-5185 (ISSN-L)
- OpenAlex
- W2039836243
- Cited by
- 920
- References
- 0
- Citations by year
- 2026: 21 · 2025: 19 · 2024: 24 · 2023: 23 · 2022: 31 · 2021: 38 · 2020: 36 · 2019: 24 · 2018: 32 · 2017: 28 · 2016: 39 · 2015: 44 · 2014: 50 · 2013: 29 · 2012: 26
- FWCI
- 6.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Surgical Pathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Oncology › Renal cell carcinoma treatment
- Keywords
- adrenocortical tumors, adrenal metastasis, tumor recurrence, histologic grading, mitotic activity, atypical mitoses, venous invasion, capsular invasion, clear cells, tumor differentiation, adrenocortical carcinoma
- MeSH terms
- Adenoma, Adrenal Cortex Neoplasms, Adult, Aged, Carcinoma, Female, Humans, Male, Middle Aged, Mitosis, Necrosis, Neoplasm Recurrence, Local, Prognosis
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