A Case of Pediatric Virilizing Adrenocortical Tumor Resulting in Hypothalamic-pituitary Activation and Central Precocious Puberty Following Surgical Removal

Yoko MIYOSHI; Takaharu OUE; Mitsugu OOWARI; Hideki SOH; Makiko TACHIBANA; Sadami KIMURA; Yuki KIYOHARA; Hiroyuki YAMADA; Kazuhiko BESSYO; Sotaro MUSHIAKE; Keiko HOMMA; Tomonobu HASEGAWA; Hironobu SASANO; Keiichi OZONO

doi:10.1507/endocrj.K09E-146

ORIGINALS

A Case of Pediatric Virilizing Adrenocortical Tumor Resulting in Hypothalamic-pituitary Activation and Central Precocious Puberty Following Surgical Removal

Yoko MIYOSHI, Takaharu OUE, Mitsugu OOWARI, Hideki SOH, Makiko TACHIBANA, Sadami KIMURA, Yuki KIYOHARA, Hiroyuki YAMADA, Kazuhiko BESSYO, Sotaro MUSHIAKE, Keiko HOMMA, Tomonobu HASEGAWA, Hironobu SASANO, Keiichi OZONO

Author information

Yoko MIYOSHI
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Takaharu OUE
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
Mitsugu OOWARI
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
Hideki SOH
Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
Makiko TACHIBANA
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Sadami KIMURA
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Yuki KIYOHARA
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Hiroyuki YAMADA
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Kazuhiko BESSYO
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Sotaro MUSHIAKE
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
Keiko HOMMA
Central Clinical Laboratories, Keio University Hospital, Tokyo, Japan
Tomonobu HASEGAWA
Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
Hironobu SASANO
Department of Pathology, Tohoku University School of Medicine, Sendai, Japan
Keiichi OZONO
Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan

Keywords: Adrenocortical tumor, Adrenocortical carcinoma, Virilization, Precocious puberty

JOURNAL FREE ACCESS

2009 Volume 56 Issue 8 Pages 975-982

DOI https://doi.org/10.1507/endocrj.K09E-146

View "Advance Publication" version (August 12, 2009).

Details

Abstract

We present a 6-year-old boy with a virilizing adrenocortical tumor who initially presented with peripheral precocious puberty. Development of facial acne, pubic hair and a growth spurt were noted at the age of five. A low-pitched voice as well as maturation of external genitalia was noted at the age of six. Both serum and urinary levels of adrenal androgens were elevated. Abdominal computed tomography revealed a large right suprarenal mass and he underwent surgical resection without any complications. The histological diagnosis was adrenocortical carcinoma according to the criteria of Weiss. Following surgical removal of the androgen-producing tumor, the patient subsequently developed hypothalamic-pituitary activation and demonstrated central precocious puberty. He was treated with a gonadotropin-releasing hormone agonist in order to delay further pubertal progression. Clinical follow-up of potential secondary effects of excess hormone secretion after removal is important in some pediatric patients with virilizing adrenocortical tumor.

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