Table 3.
Weiss Score (17) System to Evaluate Benign Versus Malignant Adrenal Neoplasm
| Criteria | Present in adrenocortical carcinoma | Score |
|---|---|---|
| Nuclear Grade | High (grade 3 or 4)a | 1 |
| Mitotic rate | Greater than 5 per 50 HPF | 1 |
| Presence of atypical mitosis | Present | 1 |
| Clear cells | Present in 25% or less of the tumor | 1 |
| Diffuse architecture | Greater than 1/3 of the tumor | 1 |
| Necrosis | Present | 1 |
| Venous invasion | Present | 1 |
| Sinusoidal invasion | Present | 1 |
| Capsular invasion | Present | 1 |
| Total Weiss score > 3 is suggestive of adrenocortical carcinoma | ||
Abbreviation: HPF = high-power field.
a
High-grade parameters as defined by Fuhrman et al (18) in renal cell carcinoma.