Adrenocortical Tumor Arising in the Liver of a Three Year Old Boy With Signs of Virilism and Cushing's Syndrome

A case is reported of a boy of 3 years, 9 months, who presented the features of the adrenogenital syndrome. RGs showed a large calcified mass in the right upper quadrant of the abdomen. This proved to be a virilizing adrenocortical tumor, buried in the right lobe of the liver and receiving its circulation throughout the liver. Resection of four costal cartilages gave direct access to the liver through a transverse abdominal incision without the necessity for division of the diaphragm and permitted successful removal of the tumor and most of the right lobe of the liver. The tumor had no attachments to the right kidney or vena cava. There was no adrenal tissue in the usual location on the right. The child is well and developing normally two years after operation.