Abstract
Precocious puberty is commonly observed in pediatric practice due to different causes, including adrenal tumors. Adrenocortical tumors are rare in children and are characterized by an androgenic hormonal excess that causes pseudo-precocious puberty. We present the case of a four-year-old boy with a history of penile enlargement associated with the growth of pubic hair, facial acne, and three-years advanced bone age. Based on hormonal assays, the diagnosis of pseudo-precocious puberty was confirmed. Abdominal magnetic resonance imaging (MRI) revealed a right-sided, retroperitoneal, well-defined adrenal tumor. This case report emphasizes the aim to increase the awareness of adrenocortical tumor as a rare cause of pseudo-precocious puberty in young children.
Highlights
Adrenocortical tumors (ACTs) can occur at any age, they are rare in childhood [1]
The adrenocortical tumors (ACTs) is a rare neoplasm that accounts for about 0.2% of all tumors affecting children and approximately 6% of all adrenal tumors observed in the pediatric group [3]
ACT was categorized as functional, which is most commonly found in children and adolescents, or non-functional, which is usually found in adults with symptoms of abdominal discomfort or back pain caused by the large mass of the tumor [10,11]
Summary
Adrenocortical tumors (ACTs) can occur at any age, they are rare in childhood [1]. The annual incidence of ACT in children under 15 years of age is extremely rare, ranging from 0.3-0.5 cases per million [4]. The most common clinical presentation of ACT in children is pseudo-precocious puberty, which is observed in approximately 50%-84.2% of cases or as Cushing’s syndrome in the remaining cases [12,13]. We report the case of a four-year-old boy who presented with pseudo-precocious puberty caused by ACT, which is rare in children. A four-year-old boy presented to the pediatric endocrinology clinic with the appearance of pubic hair in conjunction with an increase in penile length for two months. He was delivered vaginally after a full-term pregnancy and had no medical or surgical histories. Result 0.2 0.4 0.3 0.4 0.3 0.5 0.6 0.2 0.3 0.2 0.2 0.2 0.2 0.2 39 33 Normal normal normal
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