IMPE Abstracts

Introduction: Most children and adolescents with adrenocortical tumor (ACT) present increased height age, advanced bone age and compromised predicted adult height at the time of diagnosis. Growth pattern after tumor resection and adult height data are scarce in the literature. We present a cohort of 63 completed growth patients followed in a single center of Southern Brazil.

Methods: Retrospective evaluation of patients treated for ACT between 1966 and 2021. Clinical presentation and anthropometric characteristics at diagnosis and during follow up until adult height were analyzed.

Results: The cohort male:female ratio was 1:3. Adult height was attained throughout a median of 12,4 years (2,2-19,9) after tumor resection. Median chronological age (CA) and bone age (BA) at diagnosis were 2.64 (0.01-13.41) and 5.5 years (0.62-13.5), respectively. Vast majority (90%) presented virilization at diagnosis and 67% had concomitant hypercortisolism. Tumor stages I and II represented 60% of the cohort; stage III, 33% and stage IV, 5%. Height z- score (H-SDS) at diagnosis was significantly higher than target height z-score (TH-SDS) (P<0.01), while predicted adult height z-score (PAH-SDS) was significantly smaller than H-SDS and TH-SDS (P<0.01). There was no difference in H-SDS regarding tumor endocrine profile; BA tended to equalize to CA 7 years after tumor excision, as well as PAH-SDS to both H-SDS and TH-SDS. Median adult height z score (AH-SDS) [-0.77 (-4.47-1.1] was not different of median TH-SDS [-0,75 (-2,24 a 0,53] (P=0.3). Six patients achieved AH-SDS below TH-SDS, whereas 3 surpassed TH-SDS. Concerning those without TH data, AH-SDS was <-2 in 2 cases. CA > 4 years at diagnosis [OR 13.3 (2.2-75)], time between clinical manifestation and diagnosis ≥ 1 year [OR 4.1 (4.3-386)] and occurrence of central precocious puberty [OR 8.6 (5.2-33)] were independently related to AH < TH and AH < -2 SDS when TH unavailable (P<0.05). Patients submitted to chemotherapy (n=9) had significant smaller AH-SDS (P<0.05) than that of those cured with surgery solely (n=54).

Conclusion: Overall, adult height was not different of target height despite the advanced bone age and smaller PAH at time of diagnosis.