Adrenocortical oncocytic carcinoma with recurrent metastases: a case report and review of the literature.
BACKGROUND
Adrenal cortex oncocytic carcinoma (AOC) represents an exceptional pathological entity, since only 22 cases have been documented in the literature so far.


METHODS
Our case concerns a 54-year-old man with past medical history of right adrenal excision with partial hepatectomy, due to an adrenocortical carcinoma. The patient was admitted in our hospital to undergo surgical resection of a left lung mass newly detected on chest Computed Tomography scan. The histological and immunohistochemical study revealed a metastatic AOC. Although the patient was given mitotane orally in adjuvant basis, he experienced relapse with multiple metastases in the thorax twice in the next year and was treated with consecutive resections. Two and a half years later, a right hip joint metastasis was found and concurrent chemoradiation was given. Finally, approximately five years post disease onset, the patient died due to massive metastatic disease. A thorough review of AOC and particularly all diagnostic difficulties are extensively stated.


CONCLUSIONS
Histological classification of adrenocortical oncocytic tumours has been so far a matter of debate. There is no officially established histological scoring system regarding these rare neoplasms and therefore many diagnostic difficulties occur for pathologists.
Argyriou
Pinelopi
P
Department of Pathology, Evangelismos General Hospital, Ipsilantou Str., Athens, Greece. pa7ha7@yahoo.gr
Zisis
Charalambos
C
Alevizopoulos
Nektarios
N
Kefaloyannis
Emmanuel M
EM
Gennatas
Constantine
C
Petraki
Constantina D
CD
D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D018268:Adrenocortical Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D014057:Tomography, X-Ray Computed