Cited by 818Adrenal and Paraganglionic TumorsRenal cell carcinoma treatmentSarcoma Diagnosis and Treatment

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Pathologic Features of Prognostic Significance in Adrenocortical Carcinoma

Weiss, Lawrence M., Medeiros, L. Jeffrey, Vickery, Austin L.·1989·The American Journal of Surgical Pathology

DOI 10.1097/00000478-198903000-00004

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Abstract

There are currently no well-established pathologic prognostic factors helpful in distinguishing low versus high grade adrenocortical carcinomas. The effect of 11 pathologic parameters on survival was investigated in 42 cases of adrenocortical carcinoma. Only one variable, mitotic rate, had a strong statistical association with patient outcome. The 21 patients with carcinomas with greater than 20 mitoses per 50 high power fields (hpf) had a median survival of 14 months, whereas the 21 patients with carcinomas with less than or equal to 20 mitoses had a median survival of 58 months (p less than 0.02). The presence of atypical mitoses, capsular invasion, tumor weight greater than 250 g, and size greater than 10 cm each showed a marginal statistical association with poor survival (p less than 0.06), whereas other features assessed, such as nuclear grade, presence of necrosis or of venous or sinusoidal invasion, character of the tumor cell cytoplasm, or architectural pattern, showed no statistical significance in predicting survival. It is proposed that adrenal cortical carcinomas with greater than 20 mitoses be designated high grade, whereas tumors with less than or equal to 20 mitoses be designated low grade.

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Assessment of Adrenal Cortical Neoplasms for the GU Pathologist
Whaley, R. D., Gupta, S., & Erickson, L. A. (2026) · Advances in Anatomic Pathology · doi:10.1097/pap.0000000000000526
Influence of Plasma Triglyceride Levels on Mitotane Therapeutic Drug Monitoring in Adrenocortical Carcinoma: Translational Implications from a Case Report
Cañabate, S. F., Díaz-Serrano, A., & Alaejos, Á. C. (2026) · International Journal of Translational Medicine · doi:10.3390/ijtm6010011
“As a result, a left adrenalectomy was performed, and the patient was diagnosed with an oncocytic adrenocortical neoplasm of uncertain malignant potential, according to the modified Weiss system [14] for oncocytic adrenal neoplasms.”

Authors: Weiss, L. M., Medeiros, L. J., & Vickery, A. L.
Affiliations: Stanford University (US)
Massachusetts General Hospital (US)
ORCID: Weiss, Lawrence M.
Medeiros, L. Jeffrey
Venue: The American Journal of Surgical Pathology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1989-03
Volume: 13
Issue: 3
Pages: 202-206
ISSN: 0147-5185 (ISSN-L)
DOI: 10.1097/00000478-198903000-00004
OpenAlex: W2023370041
Cited by: 818
References: 0
Citations by year: 2026: 13 · 2025: 21 · 2024: 19 · 2023: 20 · 2022: 33 · 2021: 30 · 2020: 34 · 2019: 22 · 2018: 27 · 2017: 30 · 2016: 31 · 2015: 40 · 2014: 38 · 2013: 33 · 2012: 34
FWCI: 8.11
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 › Oncology › Renal cell carcinoma treatment
Health Sciences › Medicine › Oncology › Sarcoma Diagnosis and Treatment
Keywords: adrenocortical carcinoma, prognostic factors, mitotic activity, tumor grade, survival, capsular invasion, tumor size, tumor weight, atypical mitoses, venous invasion, nuclear grade, necrosis
MeSH terms: Adolescent, Adrenal Cortex Neoplasms, Adult, Aged, Carcinoma, Child, Humans, Middle Aged, Mitotic Index, Neoplasm Invasiveness, Prognosis

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Pathologic Features of Prognostic Significance in Adrenocortical Carcinoma

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