Adrenocortical tumors in children

Imaging of pediatric adrenal tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee White Paper

Adrenal tumors other than neuroblastoma are uncommon in children. The most frequently encountered are adrenocortical carcinoma and pheochromocytoma. This paper offers consensus recommendations for imaging of pediatric patients with a known or suspected primary adrenal malignancy other than neuroblastoma at diagnosis and during follow-up.

Genitourinary Tract Tumors in Children: An Update

BACKGROUND

Genitourinary tract tumors in children are less common than in adults. Most of these tumors have different genetic backgrounds, clinical presentation, and oncologic behavior than their adult counterpart. As a result of low prevalence in children, some of the treatment approaches and recommendations are based on treatment experience in adult patients. However, thanks to scientific and technological development, survival rates have risen considerably.

OBJECTIVE

This paper presents a review of the principal features of the tumors involving the genitourinary tract in children and an update in genetic background, diagnosis, and treatment.

METHODS

A narrative review was performed on published literature about genitourinary tract tumors in pediatric patients. Papers presented in English and Spanish literature were reviewed. PubMed, Science Direct, and SciELO databases were used to collect information and present this article.

RESULTS

Kidney tumors are the most common type of genitourinary tumors in children. Among those, Wilms tumor represents the majority of cases and shows the successful work of clinical trial groups studying this tumor type. Other tumors involving the genitourinary tract in children include Rhabdomyosarcoma, Transitional cell carcinoma, Testicular, and Adrenal tumors.

CONCLUSION

Genitourinary tract tumors in children represent significant morbidity and economic burden, so awareness in early diagnosis represents improvement in treatment, clinical, and oncological outcomes.

Case Series and Review of Literature of Malignant Adrenocortical Neoplasms: Experience of Two Tertiary Centers in Saudi Arabia

Pediatric malignant adrenocortical neoplasms are among the rarest tumors encountered by pediatric surgeons and oncologists. In Saudi Arabia, only case reports exist due to the rarity of the condition. In this case series, we present five cases of malignant adrenocortical neoplasm and their clinical outcomes from two tertiary centers in Riyadh, Saudi Arabia, from 2012 to 2021. Patients ranged in age from one to eight years. We report the cases of three female and two male patients. All cases presented with hormonally active tumors. In two cases where tumors were excised with negative margins, only surgery and close follow-up were performed. In three cases, neoadjuvant and/or adjuvant therapy was required. In conclusion, for malignant adrenocortical neoplasms, the timing of diagnosis played a vital role in outcomes. Best outcome can be achieved with complete surgical excision as malignant adrenocortical neoplasms show a poor response to other treatment modalities.