Adrenal gland and paraganglia
Adrenocortical carcinoma
Staging of adrenocortical carcinoma

Topic Completed: 1 January 2018

Revised: 6 June 2019

Copyright: 2002-2019,, Inc.

PubMed Search: Staging of adrenocortical carcinoma[TI]

Debra Zynger, M.D.
Page views in 2018: 589
Page views in 2019 to date: 442
Cite this page: Zynger D. Staging of adrenocortical carcinoma. website. Accessed August 19th, 2019.

Pathologic TNM staging of adrenal cortical carcinoma, AJCC 8th edition
Primary tumor (pT)
  • pTX: Cannot be assessed
  • pT0: No evidence of primary tumor
  • pT1: Tumor ≤ 5 cm, no extra-adrenal invasion
  • pT2: Tumor > 5 cm, no extra-adrenal invasion
  • pT3: Extra-adrenal invasion but no invasion of adjacent organs
  • pT4: Invasion of kidney, diaphragm, pancreas, spleen, liver, renal vein or vena cava
Regional lymph nodes (pN)
  • pNX: Cannot be assessed
  • pN0: No regional lymph node metastasis
  • pN1: Regional lymph node metastasis (ex: paraaortic, periaortic, retroperitoneal)
Distant metastasis (pM)
  • pM1: Distant metastasis
AJCC prognostic stage groups
Stage group I: T1 N0 M0

Stage group II: T2 N0 M0
Stage group III: T1 - 2 N1 M0
T3 - 4 N0 - 1, X M0
Stage group IV: T1 - 4, X   N0 - 1, X   M1  
Gross images

Contributed by Debra Zynger, M.D.

Organ confined, ≤ 5 cm (pT1)

Organ confined, > 5 cm (pT2)

Extra-adrenal invasion (pT3)

Liver invasion (pT4)

Microscopic (histologic) images

Contributed by Debra Zynger, M.D.

Extra-adrenal adipose invasion (pT3)

Liver involvement (pT4)

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