Science and Education Publishing American Journal of Medical Case Reports 2374-216X 4 11 2016 11 30 Precocious Puberty Associated with an Adrenal Tumor: A Case Report 354 356 EN Rajkumar M. Meshram Department of Paediatrics, Government Medical College, Nagpur, Maharashtra, India Swapnil Bhongade Swapna Patil Bibhishan Jadhav Payal Laddha AJMCR20164111 10.12691/ajmcr-4-11-1 2016 7 3 2016 10 18 2016 11 28 Precocious puberty is a common complaint in pediatric medicine these days with numerous causative factors. Though adrenocortical tumors are extremely rare in children, the differential diagnosis is broad with androgen producing adrenal adenoma. Pediatric adrenocortical tumors are therapeutic and diagnostic challenges because histological criteria for distinguishing benign from malignant tumors seen in adult are not always reliable in children. Here, we report a 2 year old toddler with precocious puberty with hyperglucocortism and hypertension. His plasma testosterone, dehydroepiandrosrerone and cortisol were elevated. An abdominal MRI and CT scan identified well defined left -sided adrenal mass. Left adrenalectomy was performed and histopathological examination revealed adrenal adenoma. This case emphasizes the importance of early consideration of an adrenocortical tumor causing precocious puberty in toddler.