Suprarenal cortical tumors
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Suprarenal Cortical Tumors. Functional Classification of Adrenal Cortical Tumors. Endocrine hyperfunction: Cushing, Conn syndrome, Virilism, Feminisation, mixed Non-functional or non-hyperfunctional Functional status unknown. Carcinomas 3% Female predilection

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Functional classification of adrenal cortical tumors
Functional Classification of Adrenal Cortical Tumors

  • Endocrine hyperfunction: Cushing, Conn syndrome, Virilism, Feminisation, mixed

  • Non-functional or non-hyperfunctional

  • Functional status unknown


Carcinomas versus adenomas

Carcinomas

3%

Female predilection

80% functional: glucocorticoids

Adenomas

More common, but accidentally discovered

M:F ratio 1:1

85% non-functional

Carcinomas versus Adenomas


Carcinoma v adenoma
Carcinoma V Adenoma

Histologic Criteria Value

  • Diffuse growth pattern 0.9

  • Vascular invasion 0.9

  • Tumor cell necrosis 0.7

  • Broad fibrous bands 1.0

  • Capsular invasion 0.4

  • Mitotic activity 1/10 HPF 0.6

  • Pleomorphism: moderate /marked 0.4

Hough et al 1995


Non histologic criteria
Non-Histologic Criteria

  • Tumor mass> 100 g

  • Urinary 17-ketosteroids high

  • Response to ACTH

  • Cushing syndrome +- virilism

  • Weight loss



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