PURPOSE: The pathological diagnosis of malignancy in pheochromocytomas remains a controversial issue. According to the WHO, malignancy is defined in the presence of metastasis. Multiparameter scoring systems such as PASS (Pheochromocytoma of Adrenal gland Scaled Score) have been used but remain controversial. The aim of this study was to search for new immunohistologic elements allowing determination of pheochromocytoma malignancy. METHODS: Among 53 patients operated for pheochromocytoma between 1993 and 2009, we selected pheochromocytomas with proven metastasis, seven cases in group 1 (G1) and paired two others groups: group 2 (G2), patients who had "benign" pheochromocytoma with PASS ≥4 and group 3 (G3), patients who had "benign" pheochromocytoma with PASS <4. We retrospectively analysed PASS criteria, size, weight, tumour necrosis, Ki-67 and pS100 staining. RESULTS: The size and weight of the lesion were directly and significantly correlated to malignancy in all three groups: respectively 9.7 cm and 292.0 g (G1), 6.2 cm and 83.8 g (G2) and 3.8 cm and 37.1 g (G3) (p < 0.005 for both). Tumour necrosis (TN) was present in all G1 (p < 0.005) and respectively at 0% and 37.5% in G2 and G3. Ki-67 is directly correlated to presence of TN (p < 0.005) and malignancy (G1 14.1%, G2 1.8%, G3 2.6%; p < 0.001). All G1 had a Ki-67 index >4%, although one G3 presented an 11% Ki-67 index. There was an inverse statistically significant correlation between the three groups in staining using pS100 (p < 0.01). CONCLUSIONS: Size and weight of the pheochromocytoma are directly related to PASS and malignancy. The presence of tumour necrosis, Ki-67 index >4% and pS100 absence impose a close histopathological evaluation and follow-up with regard to cases presenting a high risk of malignancy/recurrence.
PURPOSE: The pathological diagnosis of malignancy in pheochromocytomas remains a controversial issue. According to the WHO, malignancy is defined in the presence of metastasis. Multiparameter scoring systems such as PASS (Pheochromocytoma of Adrenal gland Scaled Score) have been used but remain controversial. The aim of this study was to search for new immunohistologic elements allowing determination of pheochromocytoma malignancy. METHODS: Among 53 patients operated for pheochromocytoma between 1993 and 2009, we selected pheochromocytomas with proven metastasis, seven cases in group 1 (G1) and paired two others groups: group 2 (G2), patients who had "benign" pheochromocytoma with PASS ≥4 and group 3 (G3), patients who had "benign" pheochromocytoma with PASS <4. We retrospectively analysed PASS criteria, size, weight, tumour necrosis, Ki-67 and pS100 staining. RESULTS: The size and weight of the lesion were directly and significantly correlated to malignancy in all three groups: respectively 9.7 cm and 292.0 g (G1), 6.2 cm and 83.8 g (G2) and 3.8 cm and 37.1 g (G3) (p < 0.005 for both). Tumour necrosis (TN) was present in all G1 (p < 0.005) and respectively at 0% and 37.5% in G2 and G3. Ki-67 is directly correlated to presence of TN (p < 0.005) and malignancy (G1 14.1%, G2 1.8%, G3 2.6%; p < 0.001). All G1 had a Ki-67 index >4%, although one G3 presented an 11% Ki-67 index. There was an inverse statistically significant correlation between the three groups in staining using pS100 (p < 0.01). CONCLUSIONS: Size and weight of the pheochromocytoma are directly related to PASS and malignancy. The presence of tumour necrosis, Ki-67 index >4% and pS100 absence impose a close histopathological evaluation and follow-up with regard to cases presenting a high risk of malignancy/recurrence.
Authors: A Khorram-Manesh; H Ahlman; O Nilsson; P Friberg; A Odén; G Stenström; G Hansson; O Stenquist; B Wängberg; L-E Tisell; S Jansson Journal: J Intern Med Date: 2005-07 Impact factor: 8.989
Authors: E van der Harst; H A Bruining; H Jaap Bonjer; F van der Ham; W N Dinjens; S W Lamberts; W W de Herder; J W Koper; T Stijnen; C Proye; M Lecomte-Houcke; F T Bosman; R R de Krijger Journal: J Pathol Date: 2000-06 Impact factor: 7.996
Authors: Karel Pacak; Graeme Eisenhofer; Håkan Ahlman; Stefan R Bornstein; Anne-Paule Gimenez-Roqueplo; Ashley B Grossman; Noriko Kimura; Massimo Mannelli; Anne Marie McNicol; Arthur S Tischler Journal: Nat Clin Pract Endocrinol Metab Date: 2007-02
Authors: E Edström Elder; D Xu; A Höög; U Enberg; M Hou; P Pisa; A Gruber; C Larsson; M Bäckdahl Journal: Mod Pathol Date: 2003-03 Impact factor: 7.842
Authors: Graeme Eisenhofer; Stefan R Bornstein; Frederieke M Brouwers; Nai-Kong V Cheung; Patricia L Dahia; Ronald R de Krijger; Thomas J Giordano; Lloyd A Greene; David S Goldstein; Hendrik Lehnert; William M Manger; John M Maris; Hartmut P H Neumann; Karel Pacak; Barry L Shulkin; David I Smith; Arthur S Tischler; William F Young Journal: Endocr Relat Cancer Date: 2004-09 Impact factor: 5.678
Authors: David Taïeb; Alexandre Kaliski; Carsten C Boedeker; Victoria Martucci; Tito Fojo; John R Adler; Karel Pacak Journal: Endocr Rev Date: 2014-07-17 Impact factor: 19.871
Authors: Maithili Mandar Kulkarni; Siddhi Gaurish Sinai Khandeparkar; Sanjay D Deshmukh; R R Karekar; Vandana L Gaopande; Avinash R Joshi; Mrunal V Kesari; R R Shelke Journal: J Clin Diagn Res Date: 2016-09-01
Authors: Elise M Blanchet; David Taieb; Corina Millo; Victoria Martucci; Clara C Chen; Maria Merino; Peter Herscovitch; Karel Pacak Journal: J Nucl Med Date: 2015-09-10 Impact factor: 10.057