Abstract
A 5-year-old girl was brought to a private practitioner due to early growth of pubic hair. Her serum testosterone level was elevated to 1.25 ng/ml. Abdominal ultrasound, CT and MRI demonstrated a 6-cm-diameter tumor, which was located in the right adrenal gland. She was referred to our institution. Closer studies revealed that the tumor did not invade into the surrounding tissue and had no distant nor lymph node metastasis. Androgen-producing adrenocortical tumor was diagnosed, and laparoscopic surgery was indicated. Laparoscopy confirmed the presence of a tumor located in the right adrenal gland, in contact with the inferior vena cava and with no infiltration. Right adrenalectomy including complete tumor excision was performed. Laparoscopy is safe and feasible for dissection between the tumor and the inferior vena cava and the ligation of adrenal vessels. The tumor size was 36 × 52 × 58 mm, and its weight was 75 g. Because it is difficult to differentiate between benign and malignant tumors on the basis of only normal histopathological criteria, Wieneke’s criteria are often used. The tumor was diagnosed as adrenocortical adenoma. Her serum testosterone level decreased to the normal range, and her pubic hair disappeared. During 1 year and 6 months of follow up, she was found to be doing well, with no sign of local recurrence nor distant metastasis.
