A case report of adrenocortical carcinosarcoma with oncocytic and primitive neuroectodermal-like features

Chia Sui Kao, David J. Grignon, Thomas M. Ulbright, Muhammad T. Idrees

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Adrenocortical carcinosarcomas are rare aggressive neoplasms; only a few have been reported to date, all with dismal prognosis. These were reported as having varying morphology. We have encountered a case of adrenal carcinosarcoma with an undifferentiated component bearing similarities to primitive neuroectodermal tumors and other areas of oncocytic differentiation. The 48-year-old woman patient presented with abdominal pain and unintended, excessive weight loss. Computed tomographic imaging revealed a tumor located adjacent to the liver and kidney necessitating a partial nephrectomy and hepatectomy. Histologically, the tumor exhibited malignant features. Melan-A, inhibin, calretinin, cytokeratin AE1/AE3, synaptophysin, and neuron-specific enolase were positive immunohistochemically. The patient developed metastasis within 2 months of surgery and is currently alive with disease after chemotherapy. Adrenal carcinosarcoma is a rare highly aggressive malignancy with a wide morphologic spectrum. Recognition of variant morphology and applying correct immunohistochemical studies will aid in reaching an accurate diagnosis.

Original languageEnglish (US)
Pages (from-to)1947-1955
Number of pages9
JournalHuman pathology
Volume44
Issue number9
DOIs
StatePublished - Sep 1 2013

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Keywords

  • Adrenocortical
  • Carcinosarcoma
  • Immunohistochemistry
  • Morphology
  • PNET
  • Primitive neuroectodermal tumor
  • Sarcomatoid carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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