副腎皮質腺腫により思春期早発症をきたした男児の1例

概要

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Adrenal cortical tumor is a very rare disease, especially in childhood. More than 80% of virilization caused by adrenal cortical tumor are malignant and adrenal cortical adenoma is extremely rare. A case of precocious puberty due to adrenal cortical adenoma was reported. A 2-year-old boy was admitted with complaints of enlarged penis pubic hair, and accelerated body growth. Urinary excretion of 17-KS and concentration of serum androgen were markedly elevated, but both urinary 17-OHCS and serum cortisol were within normal ranges. IVP, CT scan, and arteriography demonstrated a calcified left suprarenal mass. A well-capsulated oval tumor originating from the left adrenal gland, 5×4×3cm in size, 40 gw was completely removed. Histological diagnosis was adrenal cortical adenoma without capsular and vascular invasion, with low frequency of mitosis. Postoperative course was uneventful and he has been well without a sign of recurrence for 2 years by the time of this report. Sixty-four cases of virilization caused by adrenal cortical tumor were collected from Japanese literature, and 9 cases (16%) of adrenal cortical adenoma were included. Adrenal cortical adenoma showed pure virilizing symptoms except a case mixed with feminization, in comparison with carcinoma.
日本小児外科学会の論文
1989-06-20