Grading adrenal gland cancer

The grade is a description of how the cancer cells look compared to normal cells. To find out the grade of adrenal gland cancer, the pathologist looks at a tissue sample from the tumour under a microscope. The main factor used to determine the grade is how often the tumour cells are dividing (measured as the number of mitosis). Other factors used to determine the grade include the weight and size of the tumour, whether cancer cells have grown into blood vessels (vascular invasion) or lymph nodes, and if there are cancer cells in the surgical margin.

How different the cancer cells are is described as differentiation.

Low grade means that the cancer cells are well differentiated. They look almost like normal cells. Lower grade cancer cells tend to be slow growing and are less likely to spread.

High grade means that the cancer cells are poorly differentiated or undifferentiated. They look less normal, or more abnormal. Higher grade cancer cells tend to grow more quickly and are more likely to spread than low-grade cancer cells.

Knowing the grade gives your healthcare team an idea of how quickly the cancer may be growing and how likely it is to spread. This helps them plan your treatment. The grade can also help the healthcare team predict future outcomes (your prognosis) and how the cancer might respond to treatment.

Expert review and references

  • American Joint Committee on Cancer. AJCC Cancer Staging Handbook. 7th ed. Chicago: Springer; 2010.
  • Lirov R, Else T, Lerario AM, Hammer GD . Adrenal tumors. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 84:1195-1204.
  • National Cancer Institute. Adrenocortical Carcinoma Treatment (PDQ®) for Health Professionals. 2015: