Virilizing Adrenal Tumor in a 3-Year-Old Girl: Diagnosis by Computed Tomographic Scan and Ultrasound

Abstract

Virilization in prepubertal children is a rare finding that is characterized by development of pubic hair, clitoral or penile enlargement, accelerated linear growth, and advanced bone age. Prompt diagnosis of the source of excess androgen production is important because of the possibility of a malignant tumor and because rapid acceleration of skeletal maturation may compromise adult stature. Certain causes of virilization, including true precocious puberty, testicular tumors, and congenital adrenal hyperplasia can frequently be excluded by history and physical examination. The major diagnostic problem is often that of preoperatively distinguishing between adrenal and ovarian tumors in virilized females. We describe a 3-year-old girl in whom a small adrenal tumor was accurately localized by computed tomography (CT) scanning and ultrasonography. Report of a Case .—The patient weighed 4,000 g at birth, and no genital abnormalities were noted in the newborn period. Height increased along the 90th-percentile line until the age of