Abstract:Pheochromocytoma (PCC) is a neuroendocrine tumor originating from chromaffin tissue in adrenal medulla. Its diagnosis and treatment are well defined in adults, but experience in children is limited. Children constitute only 10% of reported cases, the average age at presentation being 11 years. The most common presentation is sustained hypertension, which is absent in only 10% of children. We managed a 14-month-old female child with PCC, but she was not hypertensive. We report two unusual features, in this case… Show more
“…Hypertension is the most common presentation in pediatric PCC and is sustained in 90% of cases. [5,25] However, childhood PCC may present without hypertension and without a classic triad [3] of headache, palpitation, and diaphoresis as in our study. Surgical excision is the treatment of PCC and leads to cure of hypertension.…”
Section: Discussionsupporting
confidence: 41%
“…[4] PCC is well recognized for its 10% extra-adrenal location, 10% bilaterality, 10% malignant, 10% presentation in children and 10% cases without hypertension; "Rule of 10s". [5] Therefore, this study was conducted to evaluate the clinical presentation, spectrum of pathology, and management of adrenal tumors in children.…”
Context:
Adrenal tumors can arise either from cortex or from medulla; both the regions being structurally and functionally different. Current knowledge on childhood adrenocortical tumors (ACTs), the management approach, and the outcome is limited due to limited number of cases and studies. Neuroblastoma is a neoplasm of the neural crest origin and 50% arise from adrenal medulla. Pheochromocytoma (PCC) is an exciting and rare neoplasm in childhood.
Aims:
To evaluate the clinical presentation, spectrum of pathology, and management of adrenal tumors in children.
Subjects and Methods:
The study was conducted in a tertiary care pediatric institute over 5 years on children with intra-abdominal solid tumors. Adrenal tumors were diagnosed on radiological studies and postoperatively confirmed by histopathology.
Results:
Sixty-three patients were operated for intra-abdominal solid tumors, and Wilms tumor (39) was the most common finding. Of 11 cases of adrenal tumors confirmed by histopathology, eight were adrenal neuroblastoma, one 14-month-old female baby was detected as PCC, while two female children presented with the features of Cushing syndrome and virilization at the age of 3 and 7 years. Postoperatively, one of them was found to be adrenal adenoma and one was found to be adrenocortical carcinoma.
Conclusions:
ACTs are rare and potentially fatal in childhood. Complete surgical resection is the mainstay of therapy in adrenal tumors and is curative for associated hypertension. Neuroblastoma was the third common intra-abdominal solid tumor after Wilms tumor and retroperitoneal teratoma. The patient with PCC contributed to “Rule of 10s” because of the absence of hypertension and childhood occurrence.
“…Hypertension is the most common presentation in pediatric PCC and is sustained in 90% of cases. [5,25] However, childhood PCC may present without hypertension and without a classic triad [3] of headache, palpitation, and diaphoresis as in our study. Surgical excision is the treatment of PCC and leads to cure of hypertension.…”
Section: Discussionsupporting
confidence: 41%
“…[4] PCC is well recognized for its 10% extra-adrenal location, 10% bilaterality, 10% malignant, 10% presentation in children and 10% cases without hypertension; "Rule of 10s". [5] Therefore, this study was conducted to evaluate the clinical presentation, spectrum of pathology, and management of adrenal tumors in children.…”
Context:
Adrenal tumors can arise either from cortex or from medulla; both the regions being structurally and functionally different. Current knowledge on childhood adrenocortical tumors (ACTs), the management approach, and the outcome is limited due to limited number of cases and studies. Neuroblastoma is a neoplasm of the neural crest origin and 50% arise from adrenal medulla. Pheochromocytoma (PCC) is an exciting and rare neoplasm in childhood.
Aims:
To evaluate the clinical presentation, spectrum of pathology, and management of adrenal tumors in children.
Subjects and Methods:
The study was conducted in a tertiary care pediatric institute over 5 years on children with intra-abdominal solid tumors. Adrenal tumors were diagnosed on radiological studies and postoperatively confirmed by histopathology.
Results:
Sixty-three patients were operated for intra-abdominal solid tumors, and Wilms tumor (39) was the most common finding. Of 11 cases of adrenal tumors confirmed by histopathology, eight were adrenal neuroblastoma, one 14-month-old female baby was detected as PCC, while two female children presented with the features of Cushing syndrome and virilization at the age of 3 and 7 years. Postoperatively, one of them was found to be adrenal adenoma and one was found to be adrenocortical carcinoma.
Conclusions:
ACTs are rare and potentially fatal in childhood. Complete surgical resection is the mainstay of therapy in adrenal tumors and is curative for associated hypertension. Neuroblastoma was the third common intra-abdominal solid tumor after Wilms tumor and retroperitoneal teratoma. The patient with PCC contributed to “Rule of 10s” because of the absence of hypertension and childhood occurrence.
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