{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:30:22Z","timestamp":1787682622294,"version":"build-2784847793"},"reference-count":70,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Rare Tumors"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adrenal sarcomas are rare malignant tumors with structural and clinical similarities to sarcomatoid adrenocortical carcinoma. Preoperative diagnosis of tumors of the adrenal gland can be challenging and often misleading thus detaining patients from appropriate oncological strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This analysis of a case series evaluated the predictive capability of the primary clinical diagnosis in case of malignancies of the adrenal gland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty two patients were treated from 2009 to 2015 at our clinic and analyzed retrospectively. All patients had computed tomography and\/or magnet resonance imaging and a primary histopathological examination at our institution after surgery. Ten questionable cases were surveyed by a reference pathologist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve out of 32 diagnoses had to be revised (37.5%). Only 15 out of 24 tumors primarily classified as adrenocortical carcinoma were finally described as primary adrenal cancer. We found two leiomyosarcomas, one liposarcoma, one sarcomatoid adrenocortical carcinoma, and one epitheloid angiosarcoma among 12 misleading diagnoses. Other tumors turned out to be metastases of lung, hepatocellular, and neuroendocrine tumors. Larger tumors were significantly more often correctly diagnosed compared to smaller tumors. Four patients of the group of revised diagnoses died whereas all patients with confirmed diagnoses survived during the follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative assessment of tumors of the adrenal gland is still challenging. In case of wrong primary diagnosis, the prognosis could be impaired due to inadequate surgical procedures or insufficient preoperative oncological treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20363613211057746","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T06:46:31Z","timestamp":1639118791000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["The challenge to differentiate between sarcoma or adrenal carcinoma\u2014an observational study"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1616-9826","authenticated-orcid":false,"given":"Eva M","family":"Dobrindt","sequence":"first","affiliation":[{"name":"Department of Surgery, Berlin Institute of Health, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Saeger","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Hamburg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Bl\u00e4ker","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina T","family":"Mogl","sequence":"additional","affiliation":[{"name":"Department of Surgery, Berlin Institute of Health, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Bahra","sequence":"additional","affiliation":[{"name":"Department of Surgery, Berlin Institute of Health, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Pratschke","sequence":"additional","affiliation":[{"name":"Department of Surgery, Berlin Institute of Health, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Rayes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Berlin Institute of Health, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin, Germany"},{"name":"Department of General, Visceral, Thoracic and Transplant Surgery, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"bibr1-20363613211057746","first-page":"231","volume":"88","author":"Okazumi S","year":"1987","journal-title":"Nihon Geka Gakkai Zasshi"},{"key":"bibr2-20363613211057746","first-page":"89","volume":"83","author":"Mark D","year":"2014","journal-title":"Ulster Med J"},{"key":"bibr3-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-007-0536-y"},{"key":"bibr4-20363613211057746","first-page":"161","volume-title":"WHO classification of tumours of endocrine organs","author":"Giordano TJ","year":"2017","edition":"4"},{"key":"bibr5-20363613211057746","first-page":"179","volume-title":"WHO classification of tumours of endocrine organs","author":"Tischler AS","year":"2017","edition":"4"},{"key":"bibr6-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-011-1166-y"},{"key":"bibr7-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/j.prp.2009.02.012"},{"key":"bibr8-20363613211057746","first-page":"98","volume":"31","author":"Duregon E","year":"2015","journal-title":"Turk Patoloji Derg"},{"key":"bibr9-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1993.tb01245.x"},{"key":"bibr10-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/S0344-0338(96)80023-9"},{"key":"bibr11-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1177\/000313480507100302"},{"key":"bibr12-20363613211057746","doi-asserted-by":"publisher","DOI":"10.5858\/135.2.268"},{"key":"bibr13-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-014-9330-y"},{"key":"bibr14-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199109000-00011"},{"key":"bibr15-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.54.9.707"},{"key":"bibr16-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-005-0343-3"},{"key":"bibr17-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1177\/1066896914526777"},{"key":"bibr18-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1097\/PAP.0000000000000213"},{"key":"bibr19-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/j.ando.2013.09.002"},{"key":"bibr20-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2018.12.003"},{"key":"bibr21-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1210\/js.2017-00149"},{"key":"bibr22-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-017-5506-0"},{"key":"bibr23-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1186\/s12894-017-0217-3"},{"key":"bibr24-20363613211057746","first-page":"D01","volume":"13","author":"Maity K","year":"2019","journal-title":"J Clin Diagn Res"},{"key":"bibr25-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2012.03.008"},{"key":"bibr26-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2009.05.004"},{"key":"bibr27-20363613211057746","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5359.92486"},{"key":"bibr28-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1210\/er.2013-1029"},{"key":"bibr29-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-2639"},{"key":"bibr30-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199004263221705"},{"key":"bibr31-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-11-0098"},{"key":"bibr32-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s12672-011-0088-0"},{"key":"bibr33-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-015-0527-4"},{"key":"bibr34-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1590\/0100-3984.2017.0179"},{"issue":"4","key":"bibr35-20363613211057746","first-page":"4258","volume":"8","author":"Zhou Y","year":"2015","journal-title":"Int J Clin Exp Pathol"},{"key":"bibr36-20363613211057746","first-page":"132","volume":"36","author":"G\u00e2tita CE","year":"2010","journal-title":"Curr Health Sci J"},{"key":"bibr37-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.09090486"},{"key":"bibr38-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2016.10.032"},{"key":"bibr39-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-16-0467"},{"key":"bibr40-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2007.03.012"},{"key":"bibr41-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1148\/rg.295095027"},{"key":"bibr42-20363613211057746","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.10.5540"},{"key":"bibr43-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-198210000-00020"},{"key":"bibr44-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-001-0030-7"},{"key":"bibr45-20363613211057746","first-page":"885","volume":"107","author":"Johanssen S","year":"2010","journal-title":"Dtsch Arztebl Int"},{"key":"bibr46-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-019-01918-9"},{"key":"bibr47-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200966"},{"key":"bibr48-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-016-9450-7"},{"key":"bibr49-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198403000-00001"},{"key":"bibr50-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-014-2912-5"},{"key":"bibr51-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199206000-00011"},{"issue":"5","key":"bibr52-20363613211057746","first-page":"717","volume":"69","author":"Khan MS","year":"2019","journal-title":"J Pak Med Assoc"},{"key":"bibr53-20363613211057746","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2017.32.5.764"},{"key":"bibr54-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-001-0047-y"},{"key":"bibr55-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-019-01768-z"},{"key":"bibr56-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10414"},{"key":"bibr57-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds231"},{"key":"bibr58-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/S1569-9056(12)61101-4"},{"key":"bibr59-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-011-0876-6"},{"key":"bibr60-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182367ac3"},{"key":"bibr61-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1549877"},{"key":"bibr62-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-015-3283-2"},{"key":"bibr63-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2017-02591"},{"key":"bibr64-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000056"},{"key":"bibr65-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2894"},{"key":"bibr66-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq209"},{"key":"bibr67-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000377"},{"key":"bibr68-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt576"},{"key":"bibr69-20363613211057746","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2009.11.007"},{"key":"bibr70-20363613211057746","first-page":"755","volume":"3","author":"Liu J","year":"2010","journal-title":"Int J Clin Exp Pathol"}],"container-title":["Rare Tumors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20363613211057746","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20363613211057746","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20363613211057746","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T23:10:59Z","timestamp":1777590659000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20363613211057746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":70,"alternative-id":["10.1177\/20363613211057746"],"URL":"https:\/\/doi.org\/10.1177\/20363613211057746","relation":{},"ISSN":["2036-3613","2036-3613"],"issn-type":[{"value":"2036-3613","type":"print"},{"value":"2036-3613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"20363613211057746"}}