Abstract
Introduction. Adrenal cortex tumors in pediatric patients are rare and constitute less than 0.2% of all malignancies in childhood. Case development. We here present a case of an 11-month-old girl who was admitted to the Pediatric Oncology Department due to a Cushingoid appearance, severe arterial hypertension, intense virilization, high body weight, and recurrent oropharyngeal candidiasis. The imaging tests and hormonal study performed confirmed the diagnosis of a functioning adrenal tumor, with secondary Cushing’s syndrome and hyperaldosteronism. After an urgent surgical approach, hormonal levels normalized, improving all the symptoms and signs presented by the patient. Conclusions. Adrenocortical tumors in children are very rare but highly aggressive, so early diagnosis and urgent treatment are essential to prevent their progression and improve the quality of life of patients.
References
1. Riedmeier M, Decarolis B, Haubitz I, Müller S, Uttinger K, Börner K, et al. Adrenocortical carcinoma in childhood: a systematic review. Cancers (Basel) 2021;13(21):5266, https://doi.org/10.3390/cancers13215266
2. Das S, Sengupta M, Islam N, Roy P, Datta C, Mishra PK, et al. Weineke criteria, Ki-67 index and p53 status to study pediatric adrenocortical tumors: Is there a correlation? J Pediatr Surg 2016; 51: 1795-800, https://doi.org/10.1016/j.jpedsurg.2016.07.014
3. Fuqua JS. Adrenal tumors in childhood. Adv Pediatr 2021;68:227-44, https://doi.org/10.1016/j.yapd.2021.05.015
4. Pinto EM, Zambetti GP, Rodríguez-Galindo C. Pediatric adrenocortical tumours. Best Pract Res Clin Endocrinol Metab 2020; 34:101448, https://doi.org/10.1016/j.beem.2020.101448
5. Wieneke JA, Thompson LD, Heffess CS. Adrenal cortical neoplasms in the pediatric population: a clinicopathologic and immunophenotypic analysis of 83 patients. Am J Surg Pathol 2003; 27: 867-81, https://doi.org/10.1097/00000478-200307000-00001
6. Zambaiti E, Duci M, De Corti F, Gamba P, Dall’Igna P, Ghidini F, et al. Clinical prognostic factors in pediatric adrenocortical tumors: a meta-analysis. Pediatr Blood Cancer 2021; 68: e28836, https://doi.org/10.1002/pbc.28836
7. Sandru F, Petca RC, Carsote M, Petca A, Dumitrascu MC, Ghemigian A. Adrenocortical carcinoma: Pediatric aspects (Review). Exp Ther Med 2022; 23: 287, https://doi.org/10.3892/etm.2022.11216
8. Brondani VB, Fragoso MC. Pediatric adrenocortical tumor - review and management update. Curr Opin Endocrinol Diabetes Obes 2020; 27:
177-86, https://doi.org/10.1097/MED.0000000000000540
9. Alfayate R, Fajardo C, González-Clemente JM. Diagnóstico de laboratorio en endocrinología. Madrid: Nature Publishing Group; 2015. ISBN: 978-84-940238-5-9.
