Cortisol Secreting Pediatric Adrenocorical Adenoma, Managed with Robotic Posterior Retroperitoneoscopic Adrenalectomy: A Case Report with Review of Literature

Abstract

Endogenous Cushing syndrome (CS) during childhood is rare and mostly due to steroid taken for treatment of other diseases. Due to delayed diagnosis of endogenous Cushing syndrome it results high morbidity and mortality. The incidence of CS is about 2 to 3 cases per million of populations and 10% of them occur in children. Patients with endogenous CS are presented with typical features of facial plethora, weight gain, glucose intolerance, hypertention, osteoporosis, proximal body weakness, fracture opportunistic infections, easily bruising and striae. We are reporting that an 8-year-old boy presented with central body weight gain, facial plethora, hypertension, and delayed weight gain. He was diagnosed to have left suprarenal mass with imaging and corticotrophin-independent crushing’s syndrome from a laboratory profile. Although laparoscopic transperito - neal adrenalectomy is mentioned as the gold standard treatment, with the introduction of surgical robotic systems, surgeons are experiencing different approaches to adrenalectomy. Our patient was operated on with a robotic adrenalectomy through a posterior retroperitoneoscopic approach successfully, and the final histopathology report was adrenocorticaladenoma. Corti - cotrophic-independent CS is more common in young children mostly younger than 7-year old, hence our patient is 8-year old which goes with possible explanation