Ann Pediatr Endocrinol Metab.  2022 Dec;27(4):315-319. 10.6065/apem.2142100.050.

Adrenocortical carcinoma and a sporadic MEN1 mutation in a 3-year-old girl: a case report

  • 1Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 2Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 3Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea


Childhood adrenocortical carcinoma (ACC) is a rare disease that is mostly linked to familial cancer syndrome. Although the prevalence of ACC is extremely low in children, it is clinically important to diagnose ACC early because age and tumor stage are closely related to prognosis. From this perspective, understanding the underlying genetics and possible symptoms of ACC is crucial in managing ACC with familial cancer syndromes. In this report, we present the case of a 3-year-old girl who initially presented with symptoms of precocious puberty and was later found to have ACC by imaging analysis. On genetic analysis, the patient was found to have a MEN1 gene mutation. MEN1 mutations are found in patients with multiple endocrine neoplasia type 1 (MEN1), usually precipitating multiple endocrine tumors, including pituitary adenoma, parathyroid hyperplasia, and adrenal tumors. Although MEN1 mutation is usually inherited in an autosomal dominant manner, neither of the patient’s parents had the same mutation, making hers a case of sporadic MEN1 mutation with initial presentation of ACC. The clinical course and further investigations of this patient are discussed in detail in this report.


Adrenocortical carcinoma; Adrenal gland neoplasm; Multiple endocrine neoplasia; Precocious puberty


  • Fig. 1. A well circumscribed, poorly heterogeneously enhancing mass in the left adrenal gland was noted on abdominal ultrasonogram (A) and magnetic resonance imaging (B).

  • Fig. 2. Gross appearance of the resected mass.

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