Abstract
There are few descriptions of the magnetic resonance (MR) appearance of hyperfunctioning adrenocortical tumours, particularly those occurring in childhood. We studied five patients, two girls and three boys, aged 6–14.3 years, presenting with clinical syndromes of adrenocortical hyperfunction. The diagnoses were Cushing's syndrome (n = 2) virilisation (n = 2) and Conn's syndrome (n = 1). Bio chemical features suggested an adrenal lesion in each case. MR and ultrasound were performed in all five cases, with CT in four. Each patient had a functional adrenal tumour secreting either cortisol, androgens or aldosterone alone, or a combination of cortisol, androgens and oestradiol. The histological diagnosis was adenoma in four cases and tumour of indeterminate nature in one case. MR clearly showed the tumours (diameter 1.0–7.5 cm), all the lesions being of high signal intensity relative to liver on T2-weighted sequences. CT revealed an adrenal mass in each of the four patients scanned, three of which enhanced after intravenous contrast medium injection. The multiplanar imaging of MR allowed better distinction from adjacent structures and also demonstrated an unenlarged contralateral adrenal gland. In the patient with a 1-cm Conn's adenoma the lesion was more easily seen on MR than CT. Ultrasound showed the four larger tumours but was unable to visualise the contralateral adrenal or the Conn's adenoma. In conclusion, the MR appearances of four adrenocortical adenomas and one indeterminate tumour in children are described. MR has been found to be at least equal to CT in the detection of these tumours, with some possible advantages. Both techniques are superior to ultrasound.
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Daneman A, Chan HSL, Martin J (1983) Adrenal carcinoma and adenoma in children: a review of 17 patients. Pediatr Radiol 13: 11–18
Hayles AB, Hahn HB, Sprague RG, Balm RC, Priestley JT (1966) Hormone-secreting tumours of the adrenal cortex in children. Pediatrics 37: 19–25
Lee PD, Winter RJ, Green OC (1985) Virilising adrenocortical tumours in childhood: eight cases and a review of the literature. Pediatrics 76: 437–444
Jones GS, Shah KJ, Mann JR (1985) Adreno-cortical carcinoma in infancy and childhood: a radiological report of ten cases. Clin Radiol 36: 257
Federici S, Galli G, Ceccarelli PL, Ferrari M, Cicognani A, Cacciari E, Domini R (1994) Adrenocortical tumours in children: a report of 12 cases. Eur J Pediatr Surg 4: 21–25
Fishman EK, Deutch BM, Hartman DS, Goldman SM, Zerhouni EA, Siegelman SS (1987) Primary adrenocortical carcinoma: CT evaluation with clinical cor relation. AJR 148: 531–535
Hamper UM, Fishman EK, Hartman DS, Roberts JL, Sanders RC (1987) Primary adrenocortical carcinoma: sonographic evaluation with clinical and pathologic correlation in 26 patients. AJR 148: 915–919
Prando A, Wallace S, Marins JLC, Pereira RM, de Oliveira ER (1990) Sonographic findings of adrenal cortical carcinomas in children. Pediatr Radiol 20: 163–165
Godine LB, Berdon WE, Brasch RC, Leonidas JC (1990) Adrenocortical carcinoma with extension into inferior vena cava and right atrium: report of 3 cases in children. Pediatr Radiol 20: 166–168
Westra SJ, Zaninovic AC, Hall TR, Kangarloo H, Boechat MI (1994) Imaging of the adrenal gland in children. Radiographics 14:1323–1339
Trainer PJ, Grossman A (1991) The diagnosis and differential diagnosis of Cushing's syndrome. Clin Endocrinol 34: 317–330
Grossman AB, Howlett TA, Perry L, Coy DH, Savage MO, Lavender P, Rees LH, Besser GM (1988) CRF in the differential diagnosis of Cushing's syndrome: a comparison with the dexamethasone suppression test. Clin Endocrinol 29: 167–178
Tanner JM (1962) Growth at adolescence. Blackwell Scientific, Oxford, pp 28–39
Tanner JM, Whitehouse RH, Laneron N, Marshall WA, Healy MJR, Goldstein H (1983) Assessment of skeletal maturity and prediction of adult height (TW2 method). Academic, London
Falke THM, Strake TE, Sandler MP, Shaff MI, Page DL, Bloem JL, van Seters AP, Partani CL, James AE, Bluemm RG (1987) Magnetic resonance imaging of the adrenal glands. Radiographics 7: 343–370
Remer EM, Weinfield RM, Glazer GM, Quint LE, Francis IR, Gross MD, Bookstein FL (1989) Hyperfunctioning and nonhyperfunctioning benign adrenal cortical lesions: characterization and comparison with MR imaging. Radiology 171: 257–260
Francis IR, Gross MD, Shapiro B, Korobkin M, Quint LE (1992) Integrated imaging of adrenal disease (editorial) Radiology 184:1–13
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Hanson, J.A., Weber, A., Reznek, R.H. et al. Magnetic resonance imaging of adrenocortical adenomas in childhood: Correlation with computed tomography and ultrasound. Pediatr Radiol 26, 794–799 (1996). https://doi.org/10.1007/BF01396204
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DOI: https://doi.org/10.1007/BF01396204