[Management of adrenocortical carcinomas in children]

Adrenocortical carcinomas are rare in children and sometimes occur in patients with predisposing syndrome like Li-Fraumeni or Beckwith-Wiedemann syndromes. The diagnosis is often based on clinical, biological and radiological findings completed by histological examination. The gold standard of treatment remains radical surgery sometimes completed by a cytotoxic chemotherapy based on platinum-derived drugs, etoposide and doxorubicin, in association with mitotane in case of high risk of relapse. The role of radiation therapy is discussed because of the relatively frequent involvement of p53 mutations. The rarity of this type of disease and the poor prognosis of the locally advanced and metastatic forms must lead to the systematic registration of these patients and to the harmonization of the management in a national or even European level.