J Korean Surg Soc.  2012 Apr;82(4):246-250. 10.4174/jkss.2012.82.4.246.

Adrenocortical tumors in children 18 years old and younger

Affiliations
  • 1Division of Pediatric Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kimdy@amc.seoul.kr

Abstract

PURPOSE
Pediatric adrenocortical tumors (ACTs) are rare. We reviewed findings in 8 children, 18 years of age or younger, diagnosed with ACT in our institution over the past 15 years.
METHODS
We retrospectively reviewed 8 children with ACTs treated between 1996 and 2010.
RESULTS
Three girls and 5 boys were treated for ACTs; their median age at presentation was 144 months (range, 28 months to 18 years). Seven patients showed signs of endocrine dysfunction, 4 with Cushing syndrome, 2 with virilization, and 1 with hyperaldosteronism. One patient, with symptoms of hematuria, underwent a computed tomography scan, which showed an adrenal mass. The median duration of symptoms prior to resection was 6 months (range, 1 to 24 months). Five patients had adenomas and 3 had carcinomas. All underwent complete resection of the tumor, with laparoscopic adrenalectomy performed on 3 patients with adenoma and 1 with carcinoma. The median tumor weight was 12.5 g (range, 1 to 130 g) and the median tumor volume was 18.3 cm3 (range, 2.2 to 299.2 cm3). At a median follow-up of 5.1 years (range, 4 months to 15 years), all 8 patients remain alive with no recurrence of disease.
CONCLUSION
The characteristics of pediatric ACTs vary considerably. Laboratory findings, clinical hormonal features, and tumor size could not distinguish adenomas from carcinomas before surgery. Complete tumor resection was successful, with no tumor recurrence. However, the small number of patients and short follow-up period limit assessments of prognosis.

Keyword

Adrenocortical adenoma; Carcinoma; Child

MeSH Terms

Adenoma
Adrenalectomy
Adrenocortical Adenoma
Child
Cushing Syndrome
Follow-Up Studies
Hematuria
Humans
Hyperaldosteronism
Prognosis
Recurrence
Retrospective Studies
Tumor Burden
Virilism

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