Adrenocortical carcinoma with cerebral metastasis in a child: case report and review of the literature

Objective and importance: Adrenocortical carcinoma (ACC) is rare in the ped iatric population, and brain metastasis seldom occurs. Clinical presentatio n: The authors report a case of metastatic ACC to the brain in a 9-year-old patient who had an adrenal cortex neoplasm removed at 4 years of age, and was free of symptoms for 5 years. Two weeks before admission she complained of blurred vision in both eyes. Intervention: Examination revealed bilater al papilledema, and a Magnetic Resonance Imaging (MRI) of the brain reveale d a mass in the left lateral ventricle with extensive vasogenic edema and h ydrocephalus. The tumor was removed, and histopathologic examination demons trated metastatic ACC. Conclusion: Although ACC is a rare neoplasm it must be considered in the differential diagnosis of cerebral lesions in patients with a history of this tumor. Periodic long-term brain imaging is suggeste d as part of the follow up in patients with adrenocortical neoplasms. (C) 2 001 Elsevier Science B.V. All rights reserved.