Comparison of clinical characteristics between children and adults with adrenal mass

Adrenal mass (AM) is a common disease with severe health problems. Its pathogenesis is different in adults and children; therefore, this study compared the differences in the clinical characteristics of AM between adults and children.

This retrospective study collected the clinical data of participants from a pediatric and an adult institution between January 2015 and January 2025. The data primarily included gender, age, initial presentation, mass size, site of the mass, functional mass, surgery, and pathological diagnosis.

A total of 1049 AM patients were analyzed in this study, including 811 (77.3%) adults and 238 (22.7%) children. Of 238 children, 141 (59.2%) were boys, and the median age of this cohort was 2.6 years. The most common AM was hematoma (52.1%), followed by neuroblastoma (28.2%) and ganglioneuroblastoma (9.7%). In 811 adults, including 402 (49.6%) male cases, the median age at initial diagnosis was 52 years. The common AM cases included adrenocortical adenoma (68.4%), pheochromocytoma (10.4%), and myeloid lipoma (7.6%). Compared to adults, children often showed a large-sized (> 4 cm) AM, which was less functional, benign masses. Furthermore, there were statistical differences between the two paired groups (p < 0.05). Similarly, 113 (47.5%) children and 713 (87.9%) adults underwent surgery. Most children (89, 78.8%) received open surgeries, while most adults (690, 96.7%) chose minimally invasive surgeries. It was found that most AMs were incidentally detected in both children and adults.

This study showed that in children, hematoma was the most common AM followed by neuroblastoma and ganglioneuroblastoma, whereas the most commonly detected AMs included adrenocortical adenoma, pheochromocytoma, and myeloid lipoma in adults. Furthermore, significant differences were observed in some clinical characteristics of children and adults with AM.