Evidence map›Paper›PMID 36412675›Full record

ReviewClinics and practice2022

Current Understanding of "Mixed Corticomedullary Adrenal Tumor" and an Insight into Genomic Profiling.

Asad Ullah, Farah Ayman Elsaid Mohamed, Jaffar Khan, Katharine Tracy, Muhabat Khan, Samiha Mohsen, Abdul Qahar Khan Yasinzai, Kaleemullah Badini, Philip T Sobash, Saleh Heneidi and 1 more

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Review in Clinics and practice, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Asad UllahDepartment of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.ORCID 0000-0002-9435-9625
Farah Ayman Elsaid MohamedDepartment of Internal Medicine College of Medicine, Cairo University, Cairo 12613, Egypt.
Jaffar KhanDepartment of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Katharine TracyDepartment of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
Muhabat KhanDepartment of Medicine, Bolan Medical College, Sandman Provincial Hospital, Quetta 83700, Pakistan.
Samiha MohsenDepartment of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Abdul Qahar Khan YasinzaiDepartment of Medicine, Bolan Medical College, Sandman Provincial Hospital, Quetta 83700, Pakistan.ORCID 0000-0002-8146-1620
Kaleemullah BadiniDepartment of Medicine, Bolan Medical College, Sandman Provincial Hospital, Quetta 83700, Pakistan.ORCID 0000-0002-2093-6397
Philip T SobashDepartment of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.ORCID 0000-0001-9711-604X
Saleh HeneidiDepartment of Pathology, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA.
Nagla Abdel KarimDepartment of Hematology/Oncology, Inova Schar Cancer Institute, University of Virginia, Fairfax, VA 22031, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMalignant mixed corticomedullary adrenal tumors (MCMTs) are extremely rare, with limited cases reported in the literature. The pathophysiology of malignant MCMTs is not well understood; the most prevailing theories are that it is a composite tumor of embryologically derived mesodermal (adrenal cortex) and neural crest (medulla) origin, perpetuating as two distinct cell lines forming a singular mass. Clinical features and laboratory diagnosis are associated with hypersecretions of the adrenal cortex and medulla. Surgical resection is curative in an isolated tumor. We reviewed and compared cases in the literature highlighting the pathogenesis and genetics of benign and malignant MCMT.

methodsComprehensive literature analysis was conducted on PubMed and all the cases of mixed corticomedullary adrenal tumor published in English were included.

resultsMost patients were female (73.1%) with a median age of 49 in women and 50 in men. Surgery was performed in all patients, and in four patients with malignant disease, chemotherapy was used as well. Clinically, most patients presented with hypertension (69%) followed by Cushing syndrome (42%) and diabetes (19%). Tumors often produced cortisol (74%), catecholamines (50%), and adrenocorticotrophic hormone (ACTH) (38%), with lower incidence of aldosterone- (7%) or dopamine (4%)-producing tumors. Immunohistochemical staining of 96% of cases showed Chromogranin-A (73%) and Synaptophysin (62%), followed by Inhibin-α (50%), Melan-A (31%), and S-100 (23%). Of the reported four cases with malignant disease, three showed a Ki-67 index of 40-50% with one showing less than 5%.

conclusionMixed corticomedullary adrenal tumors rarely present as a malignant disease requiring chemotherapy. Most MCMTs confer a good prognosis and respond well to surgical resection, though their pathogenesis is largely up to speculation because of limited data. Current theories regarding MCMT pathogenesis should be investigated further with genetic testing. Future research on MCMT may provide ways to guide physician diagnosis and subsequent treatment for refractory cases.

Indexed as

adrenal tumorcollision theorymixed corticomedullary adrenal tumor (MCMT)

Identifiers

PMID36412675
PMCPMC9680374

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