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      Adrenocortical adenoma in a Sudanese girl with Beckwith-Wiedemann syndrome

      case-report

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          Abstract

          Background

          We report a case of right adrenocortical adenoma in a girl with features suggestive of Beckwith Wiedemann syndrome to show the importance of tumor surveillance in patients with Beckwith Wiedemann syndrome.

          Case presentation

          A 4-years-old female with features suggestive of Beckwith-Wiedemann syndrome presented with 9 months history of virilization. Hormonal investigations results showed high levels of testosterone (2.3 ng/ml, normal values 0.1–0.4 ng/ml), and DHEAS (73 ng/ml normal values 1-6 ng/ml) with normal cortisol level. Computed tomography revealed a right adrenal mass. She underwent right adrenalectomy. Histopathological examination of the resected adrenal gland showed adrenocortical adenoma. Her postoperative evaluation showed a normal testosterone level.

          Conclusion

          Adrenocortical neoplasms though rare in children are well documented in Beckwith-Wiedemann syndrome patients. So tumor surveillance protocol should be employed, even in a resource-limited setting for early tumor detection and a better outcome.

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          Most cited references8

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          Beckwith-Wiedemann syndrome.

          Beckwith-Wiedemann syndrome (BWS) is a model disorder for the study of imprinting, growth dysregulation, and tumorigenesis. Unique observations in this disorder point to an important embryonic developmental window relevant to the observations of increased monozygotic twinning and an increased rate of epigenetic errors after subfertility/assisted reproduction.
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            Risk of tumorigenesis in overgrowth syndromes: a comprehensive review.

            Overgrowth syndromes (OGS) comprise a heterogeneous group of disorders in which the main characteristic is that either weight, height, or head circumference is 2-3 standard deviations (SD) above the mean for sex and age. A striking feature of OGS is the risk of neoplasms. Here, the relative frequency of specific tumors in each OGS, topographic location, and age of appearance is determined by reviewing published cases. In some OGS (Perlman, Beckwith-Wiedemann, and Simpson-Golabi-Behmel syndromes and hemihyperplasia) more than 94% of tumors appeared in the abdomen usually before 10 years of age, mainly embryonal in type. In Perlman syndrome, only Wilms tumor has been recorded, whereas in Sotos syndrome, lympho-hematologic tumors are most frequent. Based on literature review, a specific schedule protocol for tumor screening is suggested for each OGS. A schedule with different intervals and specific tests is proposed for a more rational cost/benefit program for these disorders. Copyright 2005 Wiley-Liss, Inc.
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              Tumour surveillance in Beckwith-Wiedemann syndrome and hemihyperplasia: a critical review of the evidence and suggested guidelines for local practice.

              There is strong evidence for an association between overgrowth disorders such as Beckwith-Wiedemann syndrome and the development of neoplasia. An increased cancer risk has also been observed in individuals with isolated hemihyperplasia. We critically review the evidence for tumour surveillance in Beckwith-Wiedemann syndrome and isolated hemihyperplasia and suggest local practice guidelines.
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                Author and article information

                Contributors
                emanelnaw@hotmail.com
                sawsanaa2003@yahoo.com
                mohamedabdullah@hotmail.com
                Journal
                Int J Pediatr Endocrinol
                Int J Pediatr Endocrinol
                International Journal of Pediatric Endocrinology
                BioMed Central (London )
                1687-9848
                1687-9856
                22 November 2019
                22 November 2019
                2019
                : 2019
                : 6
                Affiliations
                [1 ]ISNI 0000 0001 0674 6207, GRID grid.9763.b, Endocrine Division, Department of Paediatrics and Child Health, Faculty of Medicine, , University of Khartoum, ; P.O.Box:102, Khartoum, Sudan
                [2 ]ISNI 0000 0001 0674 6207, GRID grid.9763.b, Department of Surgery, Faculty of Medicine, , University of Khartoum, ; Khartoum, Sudan
                Author information
                http://orcid.org/0000-0002-6691-8629
                Article
                68
                10.1186/s13633-019-0068-7
                6873727
                c9ed985b-a3db-4f9e-b2b5-aa140e3c24aa
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 22 April 2019
                : 16 October 2019
                Categories
                Case Report
                Custom metadata
                © The Author(s) 2019

                Pediatrics
                beckwith-wiedemann,adrenocortical adenoma,virilization,resource-limited setting
                Pediatrics
                beckwith-wiedemann, adrenocortical adenoma, virilization, resource-limited setting

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