Introduction: Malignant adrenocortical oncocytoma is an extremely rare neoplasm, accounting for less than 1% of primary adrenal gland tumors. Its diagnosis requires detailed histopathological evaluation using the Lin-Weiss-Bisceglia criteria and the Helsinki score, which determine the tumor’s biological behavior and prognosis.
Case Presentation: A 44-year-old male with no relevant medical history presented with an incidentally discovered right adrenal mass. Hormonal and metabolic studies were normal. After two years of follow-up, the lesion increased in size to 7.5 × 6 cm, and a right lapa- roscopic suprarenalectomy was performed without complications.
Results: Histological analysis revealed an oncocytic proliferation with focal necrosis and more than 25 mitoses per 10 high-power fields, fulfilling Lin-Weiss-Bisceglia major criteria and achieving a Helsinki score of 8, confirming malignancy.
Discussion: The combined application of the Lin-Weiss-Bisceglia and Helsinki systems improves diagnostic and prognostic accuracy in rare adrenocortical tumors. This case highlights the importance of an updated histological evaluation and long-term radiological follow-up in lesions initially considered benign.
Conclusions: This case emphasizes the clinical and diagnostic significance of malignant adrenocortical oncocytoma as a rare but potentially aggressive entity. Early detection, accurate histologic classification, and the use of modern prognostic systems are essential to optimize surgical management and improve long-term outcomes.
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Revista Científica
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