Clinical, hormonal and pathological findings in a comparative study of adrenocortical neoplasms in childhood and adulthood.
OBJECTIVE
We reviewed clinical and laboratory findings in 6 male and 32 female patients with functional adrenocortical neoplasms, and compared pediatric and adult data.


METHODS
Hormonal measurements were performed by radioimmunoassay, histological analysis was based on Weiss criteria and staging was done according to previously established guidelines.


RESULTS
Children had a higher incidence of virilization (72%), whereas in adults the predominant feature was Cushing's syndrome (60%). A high testosterone level was the most common finding in adults and children with virilization followed by high dehydroepiandrosterone sulfate, androstenedione and dehydroepiandrosterone levels. High 11-deoxycortisol levels were frequently associated with tumor recurrence. Cortisol suppression after dexamethasone was altered in 93% of patients with virilization and no clinical features, suggesting autonomous cortisol secretion.


CONCLUSIONS
No statistically significant relation was noted between tumor weight and prognosis but there was a negative correlation between patient age and prognosis since children had a more favorable followup than adults. Mixed features in both groups resulted in the worst prognosis. A Weiss criteria grade IV or greater correlated well with a poor prognosis in adults but not children, while staging was more reliable in children.
D000293:Adolescent; D000306:Adrenal Cortex Neoplasms / Q000097:blood / Q000150:complications / Q000473:pathology; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003480:Cushing Syndrome / Q000097:blood / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D014770:Virilism / Q000097:blood / Q000209:etiology
D012739:Gonadal Steroid Hormones