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Suprarenal Cortical Tumors

Suprarenal Cortical Tumors. Functional Classification of Adrenal Cortical Tumors. Endocrine hyperfunction: Cushing, Conn syndrome, Virilism, Feminisation, mixed Non-functional or non-hyperfunctional Functional status unknown. Carcinomas 3% Female predilection

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Suprarenal Cortical Tumors

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  1. Suprarenal Cortical Tumors

  2. Functional Classification of Adrenal Cortical Tumors • Endocrine hyperfunction: Cushing, Conn syndrome, Virilism, Feminisation, mixed • Non-functional or non-hyperfunctional • Functional status unknown

  3. Carcinomas 3% Female predilection 80% functional: glucocorticoids Adenomas More common, but accidentally discovered M:F ratio 1:1 85% non-functional Carcinomas versus Adenomas

  4. Carcinoma V Adenoma Histologic Criteria Value • Diffuse growth pattern 0.9 • Vascular invasion 0.9 • Tumor cell necrosis 0.7 • Broad fibrous bands 1.0 • Capsular invasion 0.4 • Mitotic activity 1/10 HPF 0.6 • Pleomorphism: moderate /marked 0.4 Hough et al 1995

  5. Non-Histologic Criteria • Tumor mass> 100 g • Urinary 17-ketosteroids high • Response to ACTH • Cushing syndrome +- virilism • Weight loss

  6. Adrenal Cortical Carcinoma

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