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Pathology Adrenal Gland 16867ef0

Which of the following is most reliable feature of malignant transformation of pheochromocytoma?

A
Presence of mitotic figures
B
Presence of metastasis to other organs
C
Vascular/ capsular invasion
D
All of the above
High-Yield Explanation
- There is no histologic feature that reliably predicts malignant pheochromocytoma. - In fact, cellular & nuclear pleomorphism including presence of giant cells & mitotic figures are often seen in benign pheochromocytomas, while cellular monotony is paradoxically associated with aggressive tumors. - Even capsular and vascular invasion may be encountered in benign lesions. - Therefore, the definitive diagnosis of malignancy in pheochromocytomas is based exclusively on presence of metastases.

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