[Analysis of morphology of adrenal pheochromocytoma as regards their potential malignancy].
BACKGROUND
Adrenal pheochromocytoma are diagnosed the most often in patients with arterial hypertension or with thyroid medullar cancer and suspicion of MEN II syndromes. The aim of the study is to analyse the morphology of pheochromocytomas on the basis of Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) in order to estimate their potential malignancy.


METHODS
Forty tumours were subjected to analysis. Mean patients age was 45.2+/-13.4 years. The diagnosis of pheochromocytoma was establish before surgery in 87.5%. 12.5% of patients were referred to surgery on the basis of tumour diameter (range 70 to 102 mm). In 20.0% of patients MEN II syndromes were diagnosed.


RESULTS
In pathological examination benign pheochromo-cytoma was diagnosed in 39 presented patients. In 1 cases malignant form of pheochromocytoma was diagnosed on the basis of lymph nodes metastases. Number of points in PASS was >or=4 in 9 of 40 tumours (22.5%). Among 35 patients operated on more than 12 months ago 2 patients died: 1 patient with malignant pheochromocytoma (PASS=8 points) and 1 patient with MEN IIA syndrome (due to disseminated thyroid medullar cancer). In remaining 7 observed patients with PASS>or=4 points neither recurrence nor metastases were diagnosed within the period of observation (13-90 months). In 1 out of patients with PASS<4 points a local recurrence was surgically removed 82 months after primary operation.


CONCLUSIONS
Analysis of pheochromocytoma in PASS is only of rough character and does not allow for clear-cut histological diagnosis of benign and malignant tumours. The only unquestionable criterion of pheochromocytoma's malignancy remain metastases.
Kajor
Maciej
M
Department of Pathology, Medical University of Silesia in Katowice, Poland.
Ziaja
Jacek
J
Lange
Dariusz
D
Król
Robert
R
Ciupińska-Kajor
Monika
M
Turska-d'Amico
Maria
M
Maka
Bogusław
B
Cierpka
Lech
L
D000310:Adrenal Gland Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018813:Multiple Endocrine Neoplasia Type 2a / Q000473:pathology; D009367:Neoplasm Staging; D010673:Pheochromocytoma / Q000145:classification / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000473:pathology
D014408:Biomarkers, Tumor