Carcinoma Adrenal Em Crianças: Estudo Longitudinal Em Minas Gerais, Brasil

Abstract

Objective: To analyze clinical, laboratory and histopathological features and the path to diagnosis establishment and treatment of patients with adrenal carcinoma (AC).Methods: Retrospective study with 13 patients assisted at the pediatric oncology service of Hospital das Clínicas, Universidade Federal de Minas Gerais, Brazil, between 2004 and 2015.Results: Age at diagnosis ranged from 1.0 to 14.8 years (median: 2.0 years). Manifestations of hypercortisolism were identified in all cases and virilization in all girls. All patients met the Weiss criteria to AC histopathological diagnosis. Immunohistochemistry was performed in 61.5% of the cases. Most patients had stage I disease (76.9%). All subjects were submitted to total tumor resection. Two patients (stages III and IV disease) received chemotherapy associated to mitotane. The only death case was that of a patient with stage IV disease. The probability of overall survival for the entire group up to 5.0 years was 92.3±7.4%. The median time between the onset of symptoms and diagnosis was 9.5 months, and 6.0 months between first visit and start of treatment.Conclusions: Low age at diagnosis, predominance of cases with localized disease and complete tumor resection - with only one case of tumor capsule rupture - can possibly explain the favorable evolution of the studied population. The long period between onset of symptoms and diagnosis highlights the importance of training pediatricians for early recognition of AC signs and symptoms.

Adrenocortical carcinoma in a 10-month-old infant: A literature review and a rare case report

“…The dexamethasone suppression test and 24-h urine-free cortisol measurement should be investigated 3 , 28 . Immunohistochemical research using p53 and Ki-67 antibodies 8 . Also, Tp53 mutation analysis makes accurate diagnosis possible 29 .…”

“…Also, it has a female predominance with a 2 : 1 ratio 5 – 7 . The clinical presentations of ACC are numerous, such as terminal hair appearance, pubertal progress, hypercortisolism, enlarged clitoris, acne, systemic arterial hypertension, weight gain, and voice change 8 . Rosana Marques-Pereira et al .…”

Adrenal Cortical Carcinoma in Infancy

“…The study by Monteiro et al 4 reported in this issue of Revista Paulista de Pediatria brings the experience of a pediatric oncology group working at a teaching hospital in the state of Minas Gerais. They present and discuss demographic, hormonal, immunohistochemical, imaging, and clinical follow-up data, comparing them with what was previously described in the literature.…”

Avaliação dos miR-214-3p, miR-150-5p, miR-142-5p, miR-708-5p, miR-34a-5p e miR-139-3p em tumores adrenocorticais da infância: correlação com achados clínicos e biológicos

“…Observamos idade média de aparecimento da doença de 40,7 meses, mediana de 22 meses e 75,9% dos pacientes com idade inferior a 4 anos, com predomínio de crianças do sexo feminino (74,3%). Esses achados são semelhantes aos descritos na literatura, na qual observa mediana de 19,5 a 60 meses (maioria 2 anos) e predomínio do sexo feminino 1,6:1 a 3,3:1 (Tabela 11) (MICHALKIEWICZ et al, 2004: MARQUES-PEREIRA et al, 2006BOER, 2008;GHAZI et al, 2013;MASTELLARO et al, 2018;MONTEIRO et al, 2019WU et al, 2019ZEKRI et al, 2020;PICARD et al, 2019;ZAMBATTI et al, 2021).…”

“…A mediana de tempo entre aparecimento dos sintomas e o diagnóstico foi de 5 meses com média de 7 meses e maior frequência de pacientes com sintomas virilizantes, isolados ou mistos, (91%) dados que também corroboram as publicações disponíveis (MICHALKIEWICZ et al, 2004: MARQUES-PEREIRA et al, 2006BOER, 2008;;GHAZI et al, 2013;MASTELLARO et al, 2018;MONTEIRO et al, 2019WU et al, 2019ZEKRI et al, 2020;PICARD et al, 2019;ZAMBATTI et al, 2021).…”