Rajkumar M. Meshram^1,, Swapnil Bhongade¹, Swapna Patil¹, Bibhishan Jadhav¹, Payal Laddha¹

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.

adrenal tumor, adrenocortical carcinoma, precocious puberty, virilization