Adrenocortical tumors in children: Sri Lankan experience from a single center, and a mini review.


Journal

Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382

Informations de publication

Date de publication:
13 Apr 2023
Historique:
received: 06 02 2023
accepted: 14 03 2023
medline: 14 4 2023
entrez: 12 4 2023
pubmed: 13 4 2023
Statut: epublish

Résumé

Pediatric adrenocortical tumors include both benign adenomas and highly virulent malignant tumors. However, they are very rare among children. The aim of this study is to evaluate the clinicopathological data of children presenting with adrenocortical tumors and assess their survival in a South Asian population. This is a retrospective cohort study that includes patients diagnosed with adrenocortical tumors from August 2020 to August 2022 followed-up at Lady Ridgeway Hospital. Seven children were diagnosed with adrenal cortical tumors. Their ages ranged from 10 months to 6.5 years. Five of them were boys. All displayed signs of peripheral precocious puberty. One boy phenotypically had features of Beckwith-Wiedemann syndrome. The median time for diagnosis after the onset of symptoms was 4.4 months. The preoperative diagnosis was based on clinical manifestations, elevated dehydroepiandrosterone sulfate levels, and suprarenal masses on computed tomography. All five boys had right-sided suprarenal masses, while the two girls had them on the left side. All underwent surgery for tumor resection. The diagnosis was confirmed based on the histopathology of the adrenal specimens. Four children had a Wieneke score of 4 or more, suggesting the possibility of adrenocortical carcinoma; however, only two of them behaved as malignant tumors. To date, two children have developed local recurrences within a very short period. Adrenocortical tumors are uncommon in children, and treatment options are limited. To identify early recurrences, routine clinical, radiological, and biochemical examinations at least once every 6-8 weeks is important.

Sections du résumé

BACKGROUND BACKGROUND
Pediatric adrenocortical tumors include both benign adenomas and highly virulent malignant tumors. However, they are very rare among children. The aim of this study is to evaluate the clinicopathological data of children presenting with adrenocortical tumors and assess their survival in a South Asian population.
CASE PRESENTATION METHODS
This is a retrospective cohort study that includes patients diagnosed with adrenocortical tumors from August 2020 to August 2022 followed-up at Lady Ridgeway Hospital. Seven children were diagnosed with adrenal cortical tumors. Their ages ranged from 10 months to 6.5 years. Five of them were boys. All displayed signs of peripheral precocious puberty. One boy phenotypically had features of Beckwith-Wiedemann syndrome. The median time for diagnosis after the onset of symptoms was 4.4 months. The preoperative diagnosis was based on clinical manifestations, elevated dehydroepiandrosterone sulfate levels, and suprarenal masses on computed tomography. All five boys had right-sided suprarenal masses, while the two girls had them on the left side. All underwent surgery for tumor resection. The diagnosis was confirmed based on the histopathology of the adrenal specimens. Four children had a Wieneke score of 4 or more, suggesting the possibility of adrenocortical carcinoma; however, only two of them behaved as malignant tumors. To date, two children have developed local recurrences within a very short period.
CONCLUSION CONCLUSIONS
Adrenocortical tumors are uncommon in children, and treatment options are limited. To identify early recurrences, routine clinical, radiological, and biochemical examinations at least once every 6-8 weeks is important.

Identifiants

pubmed: 37046342
doi: 10.1186/s13256-023-03890-5
pii: 10.1186/s13256-023-03890-5
pmc: PMC10099899
doi:

Types de publication

Case Reports Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

137

Informations de copyright

© 2023. The Author(s).

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Auteurs

Naotunna Palliya Guruge Chamidri Randika Naotunna (NPGCR)

Endocrine and Diabetic Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka. chamidr101@gmail.com.

Harankaha Vidanalage Dinendra Nishadini Siriwardana (HVDN)

Endocrine and Diabetic Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.

Balagamage Chamila Lakmini (BC)

Endocrine and Diabetic Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.

Dilhara Senani Gamage (DS)

Endocrine and Diabetic Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.

Sandani Gunarathna (S)

Pathology Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.

Malik Samarasinghe (M)

University Surgical Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.
Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Sanjeewa Gunasekara (S)

Cancer Institute, Maharagama, Sri Lanka.

Navoda Atapattu (N)

Endocrine and Diabetic Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.

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