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Introduction Adrenocortical carcinoma (ACC) is a rare malignancy, associated with poor outcome and few therapeutic options. Despite increasing attention, the knowledge about the clinical course and treatment of these tumors is limited. Objectives Survival rates in ACC are still low and the percentage of relapse is high. Thus, it is crucial to identify the prognostic factors of overall survival (OS) and recurrence‑free survival (RFS). Patients and methods This was a retrospective analysis of 66 patients diagnosed with ACC between 2002 and 2015. Results The median OS was 43.5 months, 78.19 months for stage I + II, 22.95 months for stage III, and 19.54 months for stage IV ACC. Older age, stage IV ACC, margin status R2, and no mitotane treatment were associated with poor OS. Low Ki67 and mitotic indices were related to improved OS in a univariate analysis. The median RFS was 101.1 months. Disease recurrence after potentially curative surgery was reported in 1 patient (25%) with stage I, 12 patients (46%) with stage II, and 9 patients (45%) with stage III ACC. Male sex and no mitotane treatment were associated with a reduced RFS in a multivariate analysis and higher Ki67 and mitotic indices in the univariate analysis. Conclusions Ki67 and mitotic indices should be considered as prognostic factors when planning the adjuvant treatment of ACC. Mitotane treatment may be independently associated with better outcomes regardless of the tumor stage.

This paper presents the updated Polish Neuroendocrine Tumour Network expert panel recommendations on the management of neuroendocrine neoplasms (NENs) of the stomach and duodenum, including gastrinoma. The recommendations discuss the epidemiology, pathogenesis and clinical presentation of these tumours as well as their diagnosis, including biochemical, histopathological and localisation diagnosis. The principles of treatment are discussed, including endoscopic, surgical, pharmacological and radionuclide treatment. Finally, recommendations on patient monitoring are given.

Introduction: During the last 22 years we registered 1790 patients with incidentally found adrenal tumours (AI, adrenal incidentalomas). In 351 of them, bilateral tumours were detected. The aim of our study was to analyze the character of bilateral tumours and summarize the methods of their management., Material and Methods: In the whole group of 1790 patients, there were 1311 women and 479 men, aged 11-87 years. The group of patients with bilateral adrenal tumours included 258 women and 93 men, 25-83 years old. Hormonal investigations and imaging examinations were performed to search for subclinical adrenal hyperfunction and to define the malignant potential of the tumours., Results: Sixty-nine patients were treated by surgery for oncological or endocrinological purposes (mainly pre-Cushing's syndrome). Histological findings included malignant tumours: metastases - 9, adrenal cancer - 7, and lymphomas - 5; and non-malignant tumours: adenomas - 24, nodular hyperplasia - 14, myelolipomas - 4, and pheochromocytomas - 4. Subclinical Cushing's syndrome was relatively more frequent in nodular hyperplasia (40%) than in adenomas (30%)., Conclusions: Indications for surgery were recommended in 20% of patients with bilateral AI, most frequently for adenomas, nodular hyperplasia, and oncological pathologies, with a good prognosis in the non-malignant group. (Pol J Endocrinol 2010; 61 (1): 69-73).

The neuroendocrine tumors of the stomach and duodenum constitute only minority of neoplasms in this localisation. However due to their clinical behaviour and/or hormonal syndromes they pose diagnostic and therapeutic challenge. They display distinct phenotypes, regarding their pathogenesis, pathology and clinical course. Herein we present Polish guidelines for biochemical, pathological and localisation diagnosis, and discuss therapeutic approaches, considering endoscopic and surgical treatment, pharmacological and radionuclide therapy.