<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1683-9803</journal-id>
<journal-title><![CDATA[Pediatría (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[Pediatr. (Asunción)]]></abbrev-journal-title>
<issn>1683-9803</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1683-98032025000300237</article-id>
<article-id pub-id-type="doi">10.31698/ped.52032025012</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tumor suprarrenal izquierdo en lactante mayor: reporte de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Left adrenal tumor in an older infant: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Schaerer]]></surname>
<given-names><![CDATA[Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Matoza]]></surname>
<given-names><![CDATA[Martin]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gamarra]]></surname>
<given-names><![CDATA[Natalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rivas]]></surname>
<given-names><![CDATA[Cesar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Espínola]]></surname>
<given-names><![CDATA[Carla]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Matsumura]]></surname>
<given-names><![CDATA[Kiichiro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Previsión Social Hospital Central Cirugía Pediátrica]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>52</volume>
<numero>3</numero>
<fpage>237</fpage>
<lpage>242</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1683-98032025000300237&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1683-98032025000300237&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1683-98032025000300237&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  Los tumores suprarrenales en niños son poco frecuentes y el carcinoma suprarrenal representa menos de un 10 %. La manifestación típica es el desarrollo puberal precoz.  Descripción del caso clínico:  Lactante mayor de sexo femenino, que acude por cuadro de gastroenteritis aguda; antecedente remoto de aumento del diámetro abdominal y crecimiento de vello en zona púbica, facial y abdominal. Al examen físico: abdomen globuloso, se palpa tumoración en hemiabdomen izquierdo de 15 cms de diámetro aproximadamente, consistencia duro elástica, bordes regulares, no móvil, doloroso a la palpación, RHA +. TAC abdomen y pelvis CC EV: En proyección de glándula suprarrenal izquierda proceso expansivo con densidad de partes blandas mide 103x95x111 mm. Analítica: Cortisol 43,53 ug/ dl DHEA &gt;3000 ug/ dl TESTOSTERONA 2191 ug/ dl. Tratamiento quirúrgico: Exéresis de la masa tumoral. Anatomía patológica: Carcinoma de corteza suprarrenal de alto grado histológico de 14 cms, 616 gramos. TNM pT2 pN0.  Discusión:  El carcinoma adrenocortical pediátrico es una neoplasia poco frecuente y mayoritariamente funcional. Suelen presentarse con signos de virilización y, en menor medida, hipercortisolismo, pudiendo coexistir ambos cuadros como en nuestra paciente. La tomografía computarizada es clave para el diagnóstico y estadificación, evidenciando tumores generalmente mayores de 6 cm y de morfología heterogénea. El tratamiento de elección es la resección quirúrgica completa, principal determinante del pronóstico. Se presenta el caso de una niña con tumor suprarrenal mayor de 10 cm, manejado con exéresis completa y confirmado histológicamente como carcinoma adrenocortical de alto grado.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Adrenal tumors in children are rare, and adrenal carcinoma accounts for less than 10% of cases. The typical manifestation is precocious puberty.  Case description: An older female infant presented with acute gastroenteritis; she had a remote history of increased abdominal diameter and pubic, facial, and abdominal hair growth. Physical examination revealed a distended abdomen and a palpable mass in the left lower quadrant, approximately 15 cm in diameter, with a firm, elastic consistency, regular borders, non-mobile, and tender to palpation. Bowel sounds were present. Abdominal and pelvic CT scan: The left adrenal gland showed an expansive process with soft tissue density measuring 103 x 95 x 111 mm. Laboratory results: Cortisol 43.53 µg/dL, DHEA &gt;3000 µg/dL, Testosterone 2191 µg/dL. Surgical treatment: Excision of the tumor mass. Pathology: High-grade adrenal cortex carcinoma, 14 cm, 616 grams. TNM pT2 pN0.  Discussion: Pediatric adrenocortical carcinoma is a rare and mostly functional neoplasm. It often presents with signs of virilization and, to a lesser extent, hypercortisolism; both conditions can coexist, as in our patient. Computed tomography is key for diagnosis and staging, revealing tumors generally larger than 6 cm and with heterogeneous morphology. The treatment of choice is complete surgical resection, the main determinant of prognosis. We present the case of a girl with an adrenal tumor larger than 10 cm, managed with complete excision and histologically confirmed as high-grade adrenocortical carcinoma.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Suprarrenal]]></kwd>
<kwd lng="es"><![CDATA[carcinoma]]></kwd>
<kwd lng="es"><![CDATA[niños]]></kwd>
<kwd lng="en"><![CDATA[Adrenal gland]]></kwd>
<kwd lng="en"><![CDATA[carcinoma]]></kwd>
<kwd lng="en"><![CDATA[children]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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