CORRELATION OF PATHOLOGICAL FEATURES WITH CLINICAL OUTCOME IN PEDIATRIC ADRENOCORTICAL NEOPLASIA - A STUDY OF A BRAZILIAN POPULATION

Although the relationship between pathologic features and clinical out come is well established in adult adrenocortical neoplasms, the progno stic value of these features in pediatric adrenocortical neoplasms (PA CN) is unclear. In a series of PACNs from 54 Brazilian children, the a uthors retrospectively investigated the prognostic value of histologic classification, ploidy, proliferative index, and size (as tumor weigh t or greatest diameter). Histologic classification was most predictive of clinical behavior: there were no failures in 11 adenomas, 5 failur es in 27 low-grade carcinomas, and 9 failures in 16 high-grade carcino mas (P = .0003). Tumor weight was predictive of failure in tumors weig hing greater than or equal to 100 versus < 100 g (P = .04), and a tren d was found toward failure among tumors measuring greater than or equa l to 5 cm, as opposed to those < 5 cm (P = .07). Proliferative index w as marginally related to failure (P = .05 at < 11% vs. greater than or equal to 11% and .07 at < 10% vs. greater than or equal to 10%), and ploidy was not significantly predictive of outcome (P = .25). Histolog ic type and tumor weight were the most reliable predictors of outcome in PACN.