A case of pediatric virilizing adrenocortical tumor resulting in hypothalamic-pituitary activation and central precocious puberty following surgical removal.
We present a 6-year-old boy with a virilizing adrenocortical tumor who initially presented with peripheral precocious puberty. Development of facial acne, pubic hair and a growth spurt were noted at the age of five. A low-pitched voice as well as maturation of external genitalia was noted at the age of six. Both serum and urinary levels of adrenal androgens were elevated. Abdominal computed tomography revealed a large right suprarenal mass and he underwent surgical resection without any complications. The histological diagnosis was adrenocortical carcinoma according to the criteria of Weiss. Following surgical removal of the androgen-producing tumor, the patient subsequently developed hypothalamic-pituitary activation and demonstrated central precocious puberty. He was treated with a gonadotropin-releasing hormone agonist in order to delay further pubertal progression. Clinical follow-up of potential secondary effects of excess hormone secretion after removal is important in some pediatric patients with virilizing adrenocortical tumor.
Miyoshi
Yoko
Y
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
Oue
Takaharu
T
Oowari
Mitsugu
M
Soh
Hideki
H
Tachibana
Makiko
M
Kimura
Sadami
S
Kiyohara
Yuki
Y
Yamada
Hiroyuki
H
Bessyo
Kazuhiko
K
Mushiake
Sotaro
S
Homma
Keiko
K
Hasegawa
Tomonobu
T
Sasano
Hironobu
H
Ozono
Keiichi
K
D000306:Adrenal Cortex Neoplasms / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D018268:Adrenocortical Carcinoma / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery*; D000365:Age Determination by Skeleton; D002648:Child; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D011629:Puberty, Precocious / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology