FNA cytology cannot distinguish a benign adrenal mass from adrenal carcinoma. Over-expression of TP53, IGF-2, and cyclin E are found in ACC but not a conclusive procedure.

• FNA cytology cannot distinguish a benign adrenal mass from adrenal carcinoma. It can distinguish between an adrenal tumor and a metastatic tumor.

• FNA is sometimes performed when there is a suspicion of cancer outside the adrenal gland.^[1]

• The only definitive diagnostic criterion for a malignant adrenocortical tumor is distant metastasis or the presence of local invasion. In the absence of these findings, the Weiss system is the most commonly used method for assessing the malignant behavior because of its reliability. ^[2]

• Other immunohistochemical criteria utilized include Ki-67 proliferation index, overexpression of TP53, IGF-2, and cyclin E are found in ACC but not a conclusive procedure. ^[3]

• Several markers (such as alpha-inhibin, Melan A, SF-1) can confirm the primary adrenal origin. ^[4]

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