E-ISSN: 2791-8823
Volume : 14 Issue : 1 Year : 2022
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Turkish Society for Pediatric Endocrinology and Diabetes
Feminizing Adrenocortical Tumors as a Rare Etiology of Isosexual/Contrasexual Pseudopuberty [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2022; 14(1): 17-28 | DOI: 10.4274/jcrpe.galenos.2021.2021.0170

Feminizing Adrenocortical Tumors as a Rare Etiology of Isosexual/Contrasexual Pseudopuberty

Doğuş Vurallı1, Nazlı Gönç1, Alev Özön1, Saniye Ekinci2, H. Serkan Doğan3, Serdar Tekgül3, Ayfer Alikaşifoğlu1
1Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Ankara, Turkey
2Hacettepe University Faculty of Medicine, Department of Pediatric Surgery, Ankara, Turkey
3Hacettepe University Faculty of Medicine, Department of Urology, Ankara, Turkey

INTRODUCTION: Estrogen-secreting adrenocortical tumors (ACTs) are quite rare with feminizing adrenocortical tumors (FATs) accounting for 0.37-2% of all ACTs. The aim was to evaluate clinical and hormonal characteristics of FATS as well as treatment options and follow-up in the pediatric age group.
METHODS: Medical records of children with ACTs presenting to a single center in the last two decades were reviewed. Literature review within Pubmed revealed 34 pediatric patients (22 boys) with FAT among 192 articles.
RESULTS: Among the 25 children presenting with ACTs in the last two decades, two new pediatric cases of FAT were identified, one benign and the other malignant, in two genders with different clinical presentations. Literature review showed that FATs are extremely rare tumors that are most commonly seen in men and boys presenting with gynecomastia. FATs are more common in children ≤8 years of age, with a median age at diagnosis of six years. While boys present with contrasexual pseudopuberty signs, girls present with isosexual pseudopuberty. A high estrogen level strongly supports diagnosis, while elevations in other adrenal hormones may be seen. FATs are usually malignant in adults and prognosis is generally very poor. However, in children approximately half are benign although assessment of malignant potential depends on clinical behavior of the tumor. FATs are very unpredictable so even after surgery long-term follow-up is required. FATs presenting in childhood may have a better prognosis than adult presentation tumors as most FATs in children are followed without recurrence of tumor.
DISCUSSION AND CONCLUSION: FATs are more common in children ≤8 years of age, with a median age at diagnosis of six years. FATs in childhood may have a better prognosis than in adult males.

Keywords: Adrenal adenoma, adrenal tumor, adrenocortical carcinoma, adrenocortical tumors, childhood, children, children and adolescents, estrogen

Doğuş Vurallı, Nazlı Gönç, Alev Özön, Saniye Ekinci, H. Serkan Doğan, Serdar Tekgül, Ayfer Alikaşifoğlu. Feminizing Adrenocortical Tumors as a Rare Etiology of Isosexual/Contrasexual Pseudopuberty. J Clin Res Pediatr Endocrinol. 2022; 14(1): 17-28

Corresponding Author: Doğuş Vurallı, Türkiye
Manuscript Language: English
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