Oncocytic Adrenocortical Neoplasm with Concomitant Papillary Thyroid Cancer

• Published in: Frontiers in endocrinology (Lausanne) Vol. 8; p. 384
• Main Authors: Podetta, Michele, Pusztaszeri, Marc, Toso, Christian, Procopiou, Michel, Triponez, Frédéric, Sadowski, Samira Mercedes
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 22.01.2018
• Subjects: adrenal oncocytoma; concomitant neoplasia; Endocrinology; functional adrenal neoplasm; hereditary cancer syndrome; papillary thyroid cancer; hereditary cancer syndrome; adrenal oncocytoma; concomitant neoplasia; functional adrenal neoplasm; papillary thyroid cancer
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2017.00384

Adrenal oncocytoma (AO) is an extremely rare adrenocortical neoplasm and little is known about its malignant potential, secretory properties, and hereditary origin. We present the case of a benign AO with concomitant incidentally found papillary thyroid cancer (PTC) and review similar cases in the literature. Immunohistochemistry and next-generation sequencing (NGS) were performed. A 66-year-old women was incidentally found to have a large, androgen-secreting right adrenal mass. F-Fluorodeoxyglucose positron emission tomography showed intense uptake (SUV 88.7) of this mass and found a hypermetabolic right thyroid mass. Open adrenalectomy was performed for this highly suspicious adrenal mass. Histopathology revealed benign AO that was BRAF negative, with low Ki-67, and no somatic mutation found on NGS. Thyroidectomy revealed invasive, BRAF -positive PTC. At 6 months follow-up, androgen levels returned to normal, and no recurrence was seen on imaging. To our knowledge, this is the first report of an androgen-secreting AO with concomitant PTC. Possibly the simultaneous discovery of two independent neoplasms was observed. In conclusion, this case highlights that care should be given to exclude concomitant neoplasms. Long-term and regular imaging with biochemical follow-up is warranted, since the outcome and clinical behavior of AO remains uncertain.