Adrenal gland and paraganglia
Adrenocortical carcinoma - features to report

Topic Completed: 1 August 2017

Minor changes: 16 January 2020

Copyright: 2002-2020,, Inc.

PubMed Search: Adrenocortical carcinoma features to report

Debra Zynger, M.D.
Page views in 2019: 1,385
Page views in 2020 to date: 408
Cite this page: Zynger D. Adrenocortical carcinoma - features to report. website. Accessed May 27th, 2020.
Weiss Criteria
    Weiss criteria can be evaluated to determine malignant potential:

  • High nuclear grade
  • Mitotic rate > 5 mitoses per 50 high powered (40x) fields
  • Atypical mitotic figures
  • < 25% clear cells
  • Diffuse architecture
  • Necrosis
  • Venous invasion
  • Sinusoidal invasion
  • Capsular invasion
Required features to report
The following items are necessary to establish the 8th edition AJCC pTNM stage:

  • Size (5 cm or less or > 5 cm)
  • Tumor extent (into extra-adrenal tissue or adjacent organs, renal vein or vena cava)
  • Regional lymph node status
  • Distant metastasis (if applicable)
Microscopic (histologic) images

Contributed by Debra Zynger, M.D.

Extra-adrenal adipose invasion (pT3)

High mitotic rate

Lymphovascular invasion

Myxoid variant

Oncocytic variant

Liver involvement (pT4)

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