Adrenocortical carcinoma

• flushed rounded face with pudgy cheeks ( moon face )
• obesity
• buffalo hump (rounded fatty hump high on the back just below the neck)
• short stature (impaired linear growth, may be less than 5th percentile)

Findings suggestive of virilization :

• increased body hair ( hypertrichosis ), especially on face
• pubic hair
• acne
• deepening of voice
• enlarged clitoris (girls)

Other:

• hypertension ( high blood pressure )
• hemihypertrophy (enlargement of one side of the body)
• hemangioma (rare)

Signs and Tests:

• serum cortisol levels
• 17-ketosteroids
• 17-hydroxycorticosteroids
• CT scan of the abdomen (may demonstrate a mass in the adrenal gland)
• abdominal X-ray
• abdominal MRI (may demonstrate a mass in the adrenal gland)

Treatment:
Primary treatment consists of surgical removal of the tumor . Adrenocortical carcinoma may not respond well to chemotherapy . Medications may be given to reduce production of cortisol which is responsible for many of the symptoms.

Prognosis:
The outcome is dependent on how early the diagnosis is made and whether the tumor has spread (metastasized). These tumors are often fatal within a few years.

Complications:

• metastasis (frequently to the liver and lung)
• brain tumor ( astrocytoma )

Call Your Healthcare Provider:
Call your health care provider if your child exhibits symptoms suggestive of adrenocortical carcinoma, Cushing's syndrome or has failure to grow.


This CT scan of the upper abdomen shows an adrenal metastasis (spreading of a tumor to the adrenal gland, above the kidney) in a person with lung cancer.