case_images: PMC11195442_01
case_images: Histology images. (A) Essentially solid, suggestive nest-shaped proliferation of moderately atypical cells with partially cleared cytoplasm and blastic nuclei with repeatedly prominent nucleoli. A mitotic figure can be seen slightly to the left below the center of the image (HE, 40x). (B) Only very few tumor cells show weak incomplete to complete membranous staining (below 1% of tumor cells). No significant staining of tumor-associated inflammatory cells. (IC 0%). PD-L1 score: TPS <1%; IC 0%; CPS <1. CPS, Combined Positive Score; HE, Hematoxylin and eosin; IC, Immune Cell Score; TPS, Tumor Proportion Score.
case_images: fonc-14-1406616-g001.jpg
case_images: PMC11195442_01_fonc-14-1406616-g001.jpg
case_images: f1
case_images: Histology revealed the diagnosis of a PD-L1-negative, hormone-inactive adrenocortical tumor [Tumor Proportion Score (TPS) <1%; Immune Cell Score (IC) 0%; Combined Positive Score (CPS) <1] with one hepatic metastasis (Figures 1A, B).
case_images: Timeline with relevant data from the episode of care.
case_images: fonc-14-1406616-g002.jpg
case_images: PMC11195442_01_fonc-14-1406616-g002.jpg
case_images: f2
case_images: August 2018, an adjuvant treatment with mitotane (joined by hydrocortisone substitution) was started (Figure 2). After 4 months, a CT scan showed new hepatic and os ilium bone lesions.