In this issue of AJDC, a 5-year-old Indian boy with precocious sexual development was diagnosed as having congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency.1 On ultrasound evaluation, the patient was found to have a 2.8×2.5×2.6-cm mass in the left adrenal gland. After 3 months of treatment, the ultrasound evaluation was repeated and showed a slight increase in the size of the mass. The authors state that because the tumor enlarged while the boy was receiving hormonal replacement therapy, it was necessary for it to be removed (enlargement of the tumor is not documented, however, by comparing the initial measurements by ultrasonography with the measurements of the tumor size after surgical removal); on microscopy, it was a benign adenoma.
It would seem appropriate to ask the following five questions prompted by this case report and the conclusions of the authors:
Which patients with a diagnosis of CAH should routinely
LIGHTNER ES, LEVINE LS. The Adrenal Incidentaloma: A Pediatric Perspective. Am J Dis Child. 1993;147(12):1274–1276. doi:10.1001/archpedi.1993.02160360016002
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