Diagnostic and prognostic features in adrenocortical carcinoma: a single institution case series and review of the literature

Table 5 Hough system criteria

Criteria	Numeric value
Histological
Diffuse growth pattern	0.92
Vascular invasion	0.92
Tumor cell necrosis	0.69
Broad fibrous bands	1.00
Capsular invasion	0.37
Mitotic index (>1/10 HPFs)	0.60
Pleomorphism	0.39
Nonhistologic
Tumor mass (>100 g)	0.60
Urinary 17-ketosteroids (10 mg/1 g creatinine 24 h)	0.50
Response to ACTH (17-hydroxysteroids increased two times after 50 mcg of IV ACTH)	0.42
Cushing syndrome with virilism, virilism alone, or no clinical manifestations	0.42
Weight loss (>10 lb/3 months)	2.00

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