Childhood Adrenocortical Carcinoma: A Case Report

Case Report

Austin J Clin Case Rep. 2021; 8(5): 1213.

Childhood Adrenocortical Carcinoma: A Case Report

Tripathi K*, Pande V and Agarkhedkar S

Department of Paediatrics, Dr DY Patil Medical College, India

*Corresponding author: Kriti Tripathi, Department of Paediatrics in Dr DY Patil Medical College, Pune, Maharashtra, India

Received: May 04, 2021; Accepted: May 26, 2021; Published: June 02, 2021


Adrenal tumors can arise either from cortex or from medulla; both the regions being structurally and functionally different. They are categorized as functional (hormone-secreting) or silent and as either benign or malignant. Adrenocortical Carcinoma (ACC) are rare tumors that have a bimodal distribution, although most adult ACC are non-functional, in pediatric age group, nearly 95% are functional Our case report is presented because of its rarity consisting of our patient with virilising signs at the age of one and a half years.

Keywords: Childhood adrenocortical carcinoma; Pediatric cancers

Case Presentation

A one and a half year old male child presented to us with progressive virilising signs of excessive increase in the weight and the height since 10 months, deepening of voice with increase in the growth of pubic hair since 7months, genital organs and skin changes since 1 month.

On examination the child was conscious and irritable .The vitals were stable, but the blood pressure was above the 99th centile for his age (126/94mmhg).

His height was 82.5cm (+1SD), weight was 13.5kgs (SDS + 6.03). He had signs of virilization in the form of deepening of the voice, hypertrophy of the penis, increased pubic hair and skin changes with acne. There was no palpable mass in the abdomen. There was no family history of malignancy. Laboratory investigations revealed normal hematological and biochemical parameters. Thyroid profile was within normal limits .Morning (0800 hours) serum cortisol was 12μg /dL (3.7-19.40 μg/dL) night serum cortisol was 13.60 μg/dL, both within normal limits . Other hormonal levels were as follows: dihyrdro-epiandrosterone sulfate 1401.49 μg/dL (32.7-276), 17-OHprogesterone 9.41ng/mL (1.0), and testosterone 2169.62ng/mL (7- 20).

Ultrasound of abdomen revealed a solid hypoechoic lesion of 49mm in size in the right suprarenal region without calcification or cystic component with the lesion being hypovascular on doppler mode. Computed Tomography (CT) of the abdomen showed a mildly heterogenous enhancing lesion measuring 5.3 cm *3.7 cm in the right suprarenal fossa, in close relation to the liver and the superior pole of the right kidney. The right adrenal was not seen separately from the lesion. Mild mass effect on the superior pole of the right kidney was present. No obvious calcification or necrosis noted in the lesion (Figure 1 and 2).

Citation: Tripathi K, Pande V and Agarkhedkar S. Childhood Adrenocortical Carcinoma: A Case Report. Austin J Clin Case Rep. 2021; 8(5): 1213.