Unusual adrenal cortical tumor of unknown biologic potential: A nodule in a nodule in a nodule
Pediatric and Developmental Pathology
Adrenal adenoma; Loss of heterozygosity; Oncocytic
Adrenocortical tumors are uncommon neoplasms in childhood. Most pediatric adrenal tumors are virilizing and carcinomas are more common than adenomas. Recent molecular data suggest an adenoma-to-carcinoma progression sequence in adrenal cortical neoplasms. We report a case of a 5-year-old boy who presented with virilizing symptoms secondary to an adrenal tumor that was resected laparoscopically. The bulk of the tumor was a large, yellow mass with typical features of an adrenal cortical adenoma. In the center was a well-circumscribed tan-brown nodule that was distinct from the adenoma and had oncocytic features. A third minute focus (3.0 mm) was noted that was not circumscribed or encapsulated, but showed marked pleomorphism and abundant mitoses, including atypical forms and increased Ki67 compared with the outer 2 nodules. Molecular analysis to assess the clonality and mutation rates of the 3 distinct areas showed only 2 genetic loci with allelic imbalances. © 2005 Society for Pediatric Pathology.
Ranganathan, S., Lynshue, K., Hunt, J., Kane, T., & Jaffe, R. (2005). Unusual adrenal cortical tumor of unknown biologic potential: A nodule in a nodule in a nodule. Pediatric and Developmental Pathology, 8 (4). http://dx.doi.org/10.1007/s10024-005-1123-3