title: Usefulness of Wieneke criteria in assessing morphologic characteristics of adrenocortical tumors in children.
abstract: OBJECTIVE
  Adrenocortical tumors (ACT) occur rarely in pediatric age group. Pediatric ACTs behave differently from their histologically similar adult counterparts and standard adult criteria often cannot accurately predict their clinical behavior. The aim of the present study was to document the clinicopathologic spectrum of pediatric ACTs and to assess the utility of Wieneke scoring system in predicting clinical behavior of these tumors.
  
  
  METHODS
  This multi-institutional study comprised of 13 cases of pediatric ACTs from January 2005 to May 2014. Clinical features and gross pathologic characteristics were obtained from records. Comprehensive analyses of microscopic features were performed. Each tumor was assessed according to criteria proposed by Wieneke et al. and was assigned to benign, intermediate for malignancy or malignant group. The standard adult Weiss criteria were also applied for comparison.
  
  
  RESULTS
  There were total 6 cases of adrenocortical adenomas and 7 cases of adrenocortical carcinomas. Most of the children (76.9%) presented with endocrine dysfunction. Lower age of presentation was significantly associated with better prognosis. Applying Wieneke criteria, there were 6 benign and 6 malignant cases and one case was assigned to intermediate for malignancy group. The clinical behavior of all the cases was consistent with Wieneke criteria categorization. Applying Weiss criteria, 3 cases with benign clinical behavior were assigned to malignant group.
  
  
  CONCLUSIONS
  Our study validates the reliability of Wieneke scoring system in predicting malignancy in pediatric ACTs. It is simple and easy to use and therefore useful in day-to-day practice.
authors.affiliation: Department of Pathology, IPGME&R, Kolkata, India, gauravchatnobel@gmail.com.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Chatterjee
authors.forename: Shatavisha
authors.initials: S
authors.lastname: DasGupta
authors.forename: Gautam
authors.initials: G
authors.lastname: Mukherjee
authors.forename: Moumita
authors.initials: M
authors.lastname: Sengupta
authors.forename: Paromita
authors.initials: P
authors.lastname: Roy
authors.forename: Indu
authors.initials: I
authors.lastname: Arun
authors.forename: Chhanda
authors.initials: C
authors.lastname: Datta
authors.forename: Prafulla Kumar
authors.initials: PK
authors.lastname: Mishra
authors.forename: Sugato
authors.initials: S
authors.lastname: Banerjee
authors.forename: Uttara
authors.initials: U
authors.lastname: Chatterjee
mesh_terms: D000293:Adolescent; D000302:Adrenal Cortex / Q000473:pathology* / Q000648:ultrastructure; D000306:Adrenal Cortex Neoplasms / Q000473:pathology* / Q000648:ultrastructure; D018246:Adrenocortical Adenoma / Q000473:pathology* / Q000648:ultrastructure; D018268:Adrenocortical Carcinoma / Q000473:pathology* / Q000648:ultrastructure; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009361:Neoplasm Invasiveness; D015203:Reproducibility of Results; D012189:Retrospective Studies; D047368:Tumor Burden