Clinical characteristics of adrenal tumors in children: a retrospective review of a 15-year single-center experience

Adrenal tumors are rare in children. The aim of this study is to review and analyze clinical data on the diagnosis and management of adrenal tumors in children.

Between 2001 and 2015, 48 pediatric patients (<14 years old) admitted to our institute with adrenal tumors were reviewed. Clinical features, imaging studies, surgical approaches, as well as pathological diagnoses were recorded.

The series comprised 28 males and 20 females. Adrenomedullary tumors were 37, including 24 cases of neuroblastoma, 10 cases of ganglioneuroma, 2 cases of ganglioneuroblastoma, and 1 case of pheochromocytoma. Adrenocortical tumors were 10: 9 cases of cortical adenoma and 1 case of cortical cancer. The other one was hematoma. Fever, pain, and abdominal distention were the main clinical manifestations of adrenomedullary tumors, while Cushing syndrome was the most frequent presenting symptom of adrenocortical tumors. Both computed tomography and magnetic resonance imaging showed a high diagnostic yield. Some patients had an elevated hormone level. Open adrenalectomy was performed in 40 patients (83.3%), while a laparoscopic approach was employed in eight patients (16.7%).

Adrenal tumors in children have various types,as well as clinical manifestations. Imaging and laboratory data could be useful for differentiation of malignant from benign tumor. Final diagnosis depends on pathology. Surgical excision of the adrenal tumors is the standard of care.