Key result
Radical adrenalectomy improves LVEF by ~38% in a pediatric case of adenoma-induced severe heart failure.
Why the study?
Functional adrenal adenoma is uncommon in children, and cardiovascular complications such as dilated cardiomyopathy and heart failure are rare as initial manifestations.
Demonstrates that severe dilated cardiomyopathy and heart failure secondary to a functional adrenal adenoma in a child can be fully reversed following surgical resection.
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May warrant screening for adrenal tumors in unexplained pediatric cardiomyopathy; leaves open generalizability of reversibility beyond this case.
Background Functional adrenal adenoma is uncommon in children, and cardiovascular complications, such as dilated cardiomyopathy and heart failure (HF), are rare as initial manifestations. Case summary Here, we report a 10-year-old girl presenting with acute HF, mild troponin rise and severe left ventricular dysfunction in echocardiography. The CMR demonstrated dilated cardiomyopathy (LVEF=17%) with concentric LVH and a focal myocardial infarction. Extracardiac findings in CMR showed an incidental 3-cm right adrenal mass, and subsequent dedicated MRI with adrenal protocol showed features of a benign adenoma. Laboratory findings showed mixed Cushing's and hyperaldosteronism suggestive of a functional adrenal adenoma. The radical right adrenalectomy was performed, and pathology confirmed the diagnosis. Discussion In the one-year follow-up echocardiography, the LVEF was back to normal (LVED 55%), highlighting the reversible nature of cardiomyopathy in this condition.
Eini et al. (2026) studied this question. Radical adrenalectomy in a 10-year-old with functional adrenal adenoma and severe heart failure normalized LVEF from 17% to 55% over one year, showing reversibility.
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