Moriyama Shingo, Takeshita Hideki, Araki Saori, Tokairin Takuo, Kagawa Makoto, Chiba Koji, Adachi Akiko, Noro Akira
Department of Urology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
Department of Pathology, Saitama Red Cross Hospital, Saitama 338-8553, Japan.
Oncol Lett. 2016 Aug;12(2):1489-1492. doi: 10.3892/ol.2016.4776. Epub 2016 Jun 23.
Evaluation of the malignant potential of a pheochromocytoma (PCC) remains controversial. PCC is regarded as a neuroendocrine tumor (NET), and the classification of NETs has gradually been defined over the last decade, particularly for gastroenteropancreatic NET. The present study describes a case of locally advanced, carcinoma-like, nonfunctional PCC, which may be regarded as neuroendocrine carcinoma (NEC) rather than a malignant PCC. A 72-year-old man was referred to Saitama Red Cross Hospital (Saitama, Japan), presenting with a 2-month history of right flank pain. Computed tomography revealed a right adrenal gland tumor, which measured 6.0 cm in diameter, invading the hilum of the right kidney, liver and inferior vena cava (IVC). Radical surgery was performed with en bloc resection of the right kidney, and adjacent parts of the liver and IVC. Immunohistochemical examination demonstrated that all of the resected tissues were positive for cytokeratin AE1/AE3, chromogranin A, synaptophysin, cluster of differentiation 56 and Ki-67, and the specimen had a Ki-67 index of 80%. A diagnosis of carcinoma-like PCC or NEC of the adrenal gland was confirmed. Reports of NEC of the adrenal gland are extremely rare in the literature, and classification of PCC as a NET has not yet been fully discussed. The present case may therefore contribute to the classification of NETs in the adrenal gland.
嗜铬细胞瘤（PCC）恶性潜能的评估仍存在争议。PCC被视为一种神经内分泌肿瘤（NET），在过去十年中，NET的分类逐渐明确，尤其是胃肠胰NET。本研究描述了一例局部晚期、癌样、无功能的PCC病例，该病例可能应被视为神经内分泌癌（NEC）而非恶性PCC。一名72岁男性因右侧胁腹疼痛2个月就诊于日本埼玉红十字医院。计算机断层扫描显示右肾上腺肿瘤，直径6.0 cm，侵犯右肾门、肝脏和下腔静脉（IVC）。行根治性手术，整块切除右肾、肝脏及IVC的相邻部分。免疫组织化学检查显示，所有切除组织的细胞角蛋白AE1/AE3、嗜铬粒蛋白A、突触素、分化簇56和Ki-67均呈阳性，标本的Ki-67指数为80%。确诊为肾上腺癌样PCC或NEC。肾上腺NEC的文献报道极为罕见，PCC作为NET的分类尚未得到充分讨论。因此，本病例可能有助于肾上腺NET的分类。
