Complete hormonal workup is essential in the management of adrenocortical tumors in children

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: MON 1-36-Adrenal Incidentaloma & Carcinoma
Monday, June 17, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board MON-19
E. Nazli Gonc*1, Alev Ozon2, Meltem D Cakir3, Ayfer Karabulut Alikasifoglu4 and Nurgun Kandemir1
1Hacettepe University Faculty of Medicine, Ankara, Turkey, 2Hacettepe Univ Med Faculty, Ankara, Turkey, 3Hacettepe Univerisity Faculty of Medicine, Ankara, 4Hacettepe Univ-School of Med, Ankara, Turkey
The aim of this study is to analyze the impact of complete hormonal assessment regardless of the clinical presentation in hormone secreting adrenocortical tumors (ACT) in childhood.

Fifteen children with ACT were retrospectively analyzed regarding the association of hormonal workup at diagnosis with the clinical findings and, as well as the frequency of adrenal suppression after tumor removal.

Fourteen of 15 patients had functional ACT. Clinical findings suggested isolated virilization in 40% of the patients whereas 20%  had signs of Cushing syndrome alone, 26%  a mixture of symptoms Hormonal workup revealed  elevated cortisol levels in 33.3% of children with isolated virilization, and elevated androgen levels in 66.6% of children who had signs of Cushing’s syndrome solely .

Nine patients had adrenal suppression following tumor removal which lasted between1-24 months. Three of these patients did not have any clinical signs of Cushing syndrome preoperatively. Two of the three lacking symptoms of Cushing had excess cortisol secretion.

Conclusion: Complete hormonal workup in children with ACT showed the predominance of mixed hormone secreting type of tumor in the patients who lacked the appropriate clinical findings. Also patients lacking Cushing syndrome had excess cortisol, and postoperative adrenal suppression. Our findings suggest that clinical findings may not reflect abnormal hormone secretion in all cases, and tumor markers as well as risk of postoperative adrenal suppression can best be determined by complete hormonal evaluation at the time of diagnosis.

Nothing to Disclose: ENG, AO, MDC, AKA, NK

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