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Adrenocortical tumors, while rare in childhood, exhibit aggressive traits, often diagnosed in early childhood or during adolescence. This case report centers on an 8-year-old girl presenting with severe virilization, hirsutism, and sound harshness, persisting for 8 months. Prior medical treatments had been administered thrice before her admission to the pediatric ward for further investigation.
Imaging studies revealed a sizable homogeneous mass measuring 65x52x53 mm in the right adrenal gland. Laboratory tests indicated elevated adrenal androgens. Postoperative pathology identified the mass as an adrenocortical neoplasm, favoring a benign type, with a tumor weight of 125 grams and a size of 7 cm. The report indicated no identified venous invasion, extension into peripheral tissue, capsular invasion, tumor necrosis, or atypical mitosis.
Notably, while virilization was present in 60% of cases, in this instance, it was predominantly associated with Cushingoid features. The findings corroborate prior studies noting a predilection for right-sided carcinomas, and they highlight the delayed presentation of adenomas, contrasting with the earlier presentation of carcinomas in childhood adrenocortical tumors.