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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Main Authors: 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
Format: Article
Language:English
Published: SAGE Publishing 2025-04-01
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.
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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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