Was It an Adrenocortical Adenoma or an Adrenocortical Carcinoma? Limitation of the Weiss Scoring System in Determining the Malignant Potential of Adrenocortical Tumor: Report on Two Cases
Table 4
Suggested pathological diagnosis of the adrenocortical tumor at the first operation of Patient A based on different classification systems on retrospective pathology review. The tumor would have been classified as ACA by the majority of systems.
Clinical features
Weiss
Hough
Van Slooten
Modified Weiss
Reticulin algorithm
Helsinki score
Case 1
Diffuse growth clear cells < 25%
Diffuse growth (0.92). Cushing’s syndrome with virilism (0.42). Insufficient data on ACTH response, 24-hr urinary 17-ketosteroids, and tumor mass
Loss of normal architecture (1.6)
Clear cells <25% (2)
Mandatory criteria not available but optional criteria not met
Criteria on mitoses and necrosis not met and PI not available
