Challenges in surgical pathology of adrenocortical tumours

Lori A. Erickson

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations


Adrenocortical carcinomas are rare tumours that can be diagnostically challenging. Numerous multiparametric scoring systems and diagnostic algorithms have been proposed to differentiate adrenocortical adenoma from adrenocortical carcinoma. Adrenocortical neoplasms must also be differentiated from other primary adrenal tumours, such as phaeochromocytoma and unusual primary adrenal tumours, as well as metastases to the adrenal gland. Myxoid, oncocytic and sarcomatoid variants of adrenocortical tumours must be recognized so that they are not confused with other tumours. The diagnostic criteria for oncocytic adrenocortical carcinoma are different from those for conventional adrenocortical carcinomas. Adrenocortical neoplasms in children are particularly challenging to diagnose, as histological features of malignancy in adrenocortical neoplasms in adults may not be associated with aggressive disease in the tumours of children. Recent histological and immunohistochemical studies and more comprehensive and integrated genomic characterizations continue to advance our understanding of the tumorigenesis of these aggressive neoplasms, and may provide additional diagnostic and prognostic utility and guide the development of therapeutic targets.

Original languageEnglish (US)
Pages (from-to)82-96
Number of pages15
Issue number1
StatePublished - Jan 1 2018


  • adrenal
  • adrenocortical
  • carcinoma
  • Ki67
  • molecular
  • myxoid
  • oncocytic
  • steroidogenic factor
  • TP53
  • β-catenin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology


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