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Cushing Syndrome in a 6-Month-Old Infant due to Adrenocortical Tumor

Elizabeth B Fudge1, Daniel von Allmen, Keith E Volmar

  • 1Division of Pediatric Endocrinology, University of North Carolina, Chapel Hill, NC 27599, USA.

International Journal of Pediatric Endocrinology
|January 6, 2010
PubMed

Insights

Pediatric Cushing syndrome, rare in infants, can stem from adrenocortical carcinoma. Surgical removal of an infant

Area of Science:

  • Pediatric Endocrinology
  • Pediatric Oncology
  • Surgical Oncology

Background:

  • Cushing syndrome is rare in infancy.
  • Adrenocortical tumors (ACT) are a common cause of pediatric Cushing syndrome.
  • Early diagnosis and treatment are crucial for favorable outcomes.

Observation:

  • A six-month-old infant presented with growth failure, weight gain, acne, and irritability.
  • Clinical signs included obesity, hypertension, and Cushingoid features.
  • Biochemical tests revealed elevated cortisol and suppressed ACTH, with an adrenal mass identified on MRI.

Findings:

  • The infant had Cushing syndrome secondary to adrenocortical carcinoma.
  • Surgical resection of the right adrenal mass was successful.
  • Pathology confirmed capsular and vascular invasion, despite a low mitotic rate.

Implications:

  • Adrenocortical neoplasms should be considered in the differential diagnosis of infant Cushing syndrome.
  • Complete surgical excision is the primary treatment modality.
  • Long-term surveillance is necessary to monitor for recurrence.

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