What are the pathologic criteria for distinguishing benign from malignant adrenal cortical neoplasms? What diseases should be considered for the differential diagnosis? Are there significant differences in clinical behavior between adult and pediatric adrenal cortical neoplasms?


One of the important criteria for malignancy is tumor size. Tumors weighing >100g make up more than 90% of adrenal cortical carcinomas and only 6% of cortical adenomas. The presence of hemorrhage and/or necrosis may also be indicative of malignancy. The microscopic criteria set by the Weiss group has been commonly used. Those tumors fulfilling more than three of nine features should be regarded malignant. Among the carcinomas, those with >20 mitotic figures per 50 high power fields behave more aggressively than those with <20 mitoses.


Renal Cell Carcinoma Adrenal Mass Adrenocortical Carcinoma Adrenocortical Adenoma Adrenal Cortical Carcinoma 
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