Among the most aggressive tumors is adrenocortical
carcinoma. It is still a great challenge to distinguish
between adrenocortical adenoma and carcinoma. For many
tumors, IGF2 is essential to their growth and development.
One of the genes that suppresses tumor growth is SMAD4
and one that may encourage tumorigenesis is PTTG1.
Aim of this work: Evaluation of the clinicopathological
factors, IGF2, SMAD4, and PTTG1 immuno-expression to
distinguish adrenocortical tumors and, consequently, the
therapeutic modalities. Material and Methods: A
retrospective study was conducted on selected 40 cases of
adrenocortical tumors on which immunohistochemical
expression of PTTG1, SMAD4, and IGF2- were performed
. Receiver operating characteristic (ROC) curves were
performed to assess the diagnostic performance of the
studied markers as well as clinicopathological variables in
discriminating ACA from ACC. Results: Significant
differences in tumor size, weight and high Weiss score-
were important in differentiating ACA from ACC (p