Limitation of the current Lin-Weiss-Bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the Lin-Weiss-Bisceglia criteria
Background: Oncocytic adrenocortical neoplasms (OANs) are extremely rare adrenal tumors whose diagnosis is challenging. This study aimed to identify risk factors for predicting poor prognosis in patients with OAN of uncertain malignant potential (OANUMP) and oncocytoma, OAN subtypes, and to evaluate...
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SAGE Publishing
2025-04-01
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| Series: | Therapeutic Advances in Endocrinology and Metabolism |
| Online Access: | https://doi.org/10.1177/20420188251328186 |
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| author | Byung-Chang Kim HyeJin Han Douk Kwon Shin Jeong Pak Hyeong Rok An Won Woong Kim Yu-Mi Lee Seung Hun Lee Jung-Min Koh Jae Lyun Lee Ki-Wook Chung Dong Eun Song Tae-Yon Sung |
| author_facet | Byung-Chang Kim HyeJin Han Douk Kwon Shin Jeong Pak Hyeong Rok An Won Woong Kim Yu-Mi Lee Seung Hun Lee Jung-Min Koh Jae Lyun Lee Ki-Wook Chung Dong Eun Song Tae-Yon Sung |
| author_sort | Byung-Chang Kim |
| collection | DOAJ |
| description | Background: Oncocytic adrenocortical neoplasms (OANs) are extremely rare adrenal tumors whose diagnosis is challenging. This study aimed to identify risk factors for predicting poor prognosis in patients with OAN of uncertain malignant potential (OANUMP) and oncocytoma, OAN subtypes, and to evaluate the diagnostic utility of the current Lin-Weiss-Bisceglia (LWB) criteria. Methods: We retrospectively reviewed 14 patients diagnosed with OANUMP or oncocytoma after adrenalectomy from February 2002 to May 2022. Patients re-classified as oncocytic adrenocortical carcinoma by the LWB criteria were excluded. We compared the clinicopathological and radiological features between patients with and without recurrence. Results: Among the 14 patients, recurrence occurred in 3 (21%; 2 (67%) and 1 (33%) patients with OANUMP and oncocytoma, respectively). The proportion of patients with necrosis (66.7% vs 9.1%, p = 0.093), a Helsinki score >5 (66.7% vs 9.1%, p = 0.093), and malignancy by the reticulin algorithm (66.7% vs 9.1%, p = 0.093) were higher in the recurrence group than in the no-recurrence group but were not statistically significant. The percentages of patients with an indeterminate pathological resection margin (100% vs 63.6%, p = 0.192) tended to be higher in the recurrence group than in the no-recurrence group. Of the three patients with recurrence, two had tumor necrosis on the final pathology and were classified as malignant by the reticulin algorithm. One patient diagnosed as OANUMP by the LWB criteria had tumor necrosis and was classified as malignant by the reticulin algorithm and Helsinki scoring system. Conclusion: Necrosis was associated with the recurrence of disease in patients with OANUMP according to the LWB criteria. The absence of necrosis as a major criterion in the current LWB criteria highlights its potential limitation in accurately assessing disease aggressiveness in OANs. |
| format | Article |
| id | doaj-art-e2e435e9b46d4b78a38171ae6df59a72 |
| institution | OA Journals |
| issn | 2042-0196 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | SAGE Publishing |
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| series | Therapeutic Advances in Endocrinology and Metabolism |
| spelling | doaj-art-e2e435e9b46d4b78a38171ae6df59a722025-08-20T01:48:29ZengSAGE PublishingTherapeutic Advances in Endocrinology and Metabolism2042-01962025-04-011610.1177/20420188251328186Limitation of the current Lin-Weiss-Bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the Lin-Weiss-Bisceglia criteriaByung-Chang KimHyeJin HanDouk KwonShin Jeong PakHyeong Rok AnWon Woong KimYu-Mi LeeSeung Hun LeeJung-Min KohJae Lyun LeeKi-Wook ChungDong Eun SongTae-Yon SungBackground: Oncocytic adrenocortical neoplasms (OANs) are extremely rare adrenal tumors whose diagnosis is challenging. This study aimed to identify risk factors for predicting poor prognosis in patients with OAN of uncertain malignant potential (OANUMP) and oncocytoma, OAN subtypes, and to evaluate the diagnostic utility of the current Lin-Weiss-Bisceglia (LWB) criteria. Methods: We retrospectively reviewed 14 patients diagnosed with OANUMP or oncocytoma after adrenalectomy from February 2002 to May 2022. Patients re-classified as oncocytic adrenocortical carcinoma by the LWB criteria were excluded. We compared the clinicopathological and radiological features between patients with and without recurrence. Results: Among the 14 patients, recurrence occurred in 3 (21%; 2 (67%) and 1 (33%) patients with OANUMP and oncocytoma, respectively). The proportion of patients with necrosis (66.7% vs 9.1%, p = 0.093), a Helsinki score >5 (66.7% vs 9.1%, p = 0.093), and malignancy by the reticulin algorithm (66.7% vs 9.1%, p = 0.093) were higher in the recurrence group than in the no-recurrence group but were not statistically significant. The percentages of patients with an indeterminate pathological resection margin (100% vs 63.6%, p = 0.192) tended to be higher in the recurrence group than in the no-recurrence group. Of the three patients with recurrence, two had tumor necrosis on the final pathology and were classified as malignant by the reticulin algorithm. One patient diagnosed as OANUMP by the LWB criteria had tumor necrosis and was classified as malignant by the reticulin algorithm and Helsinki scoring system. Conclusion: Necrosis was associated with the recurrence of disease in patients with OANUMP according to the LWB criteria. The absence of necrosis as a major criterion in the current LWB criteria highlights its potential limitation in accurately assessing disease aggressiveness in OANs.https://doi.org/10.1177/20420188251328186 |
| spellingShingle | Byung-Chang Kim HyeJin Han Douk Kwon Shin Jeong Pak Hyeong Rok An Won Woong Kim Yu-Mi Lee Seung Hun Lee Jung-Min Koh Jae Lyun Lee Ki-Wook Chung Dong Eun Song Tae-Yon Sung Limitation of the current Lin-Weiss-Bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the Lin-Weiss-Bisceglia criteria Therapeutic Advances in Endocrinology and Metabolism |
| title | Limitation of the current Lin-Weiss-Bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the Lin-Weiss-Bisceglia criteria |
| title_full | Limitation of the current Lin-Weiss-Bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the Lin-Weiss-Bisceglia criteria |
| title_fullStr | Limitation of the current Lin-Weiss-Bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the Lin-Weiss-Bisceglia criteria |
| title_full_unstemmed | Limitation of the current Lin-Weiss-Bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the Lin-Weiss-Bisceglia criteria |
| title_short | Limitation of the current Lin-Weiss-Bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the Lin-Weiss-Bisceglia criteria |
| title_sort | limitation of the current lin weiss bisceglia criteria in predicting poor prognosis in oncocytic adrenocortical neoplasms of uncertain malignant potential and oncocytoma diagnosed by the lin weiss bisceglia criteria |
| url | https://doi.org/10.1177/20420188251328186 |
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