Adrenal Collision Tumors
Adrenal Collision Tumors
Mohsen Khoshniat
Endocrinologist
Contents
- Definition
- components
- Pathogenesis
- Diagnosis
- Mimics
- conclusion
- Adrenal collision tumor was first reported in 1919
- Their actual prevalence is unknown
- Many adrenal collision tumors go undetected due to their small size
R.Meyer,“Beitrag zur verstandigung uber die namengebung in der geschwulstlehre,” Zentralblatt fur Allgemeine Pathologie, no. 30, pp. 291–296, 1919.
I. S. Abdullazade and G. Tezel, “A rare case of collision tumor: coexistence of adrenocortical adenoma and pheochromocytoma in the same adrenal gland,” Journal of Medical Cases, vol. 3, no. 1, pp. 63–67, 2012.
Definition
Collision Tumors
- independently coexisting neoplasms
- with different behavioral, genetic, histological features
- sharply demarcated and lack significant tissue admixture
Composite tumors
- two morphologically and immunohistochemically distinct neoplasms have actual cellular intermingling
- common driver mutation that results in divergent histology from a common source
- Otal P, et al. (1999) Imaging Features of Uncommon Adrenal Masses with Histopathologic Correlation1. http://dx.doi.org/10.1148/ radiographics.19.3.g99ma07569
- Aggarwal N, et al. (2012) Tumor-to-tumor metastasis: case report of a pulmonary adenocarcinoma metastatic to a clear cell renal cell carcinoma. Pathol Res Pract 208(1):50–52
CollisionTumors
- occur simultaneously or following each other in sequence by less than 2 months.
- may go undetected because of the small size of one component and/or sampling error
- major diagnostic problem is to exclude the possibility of malignancy in one or both of the components
- Schwartz LH, Macari M, Huvos AG, Panicek DM. Collision tumors of the adrenal gland: demonstration and characterization at MR imaging. Radiology 1996; 201: 757760.
- Siddiqi AJ, Miller FH, Kasuganti D, Nikolaidis P. Adrenal hemangioma- adenoma: an exceedingly rare adrenal collision tumor. J Magn Reson Imaging 2009; 29: 949952.
Pathogenesis
- Coincidental occurrence of two primary neoplasms within a common location
- a common carcinogenic stimulus may have altered the cellular microenvironment within the proximity of which two distinct neoplasms arise from
- first tumor may have altered the microenvironment within the organ facilitated metastatic seeding within the vicinity
- Brandwein-Gensler M, Urken M, Wang B (2004) Collision tumor of the thyroid: a case report of metastatic liposarcoma plus papillary thyroid carcinoma. Head Neck 26(7):637–641
