Giant virilizing adrenocortical carcinoma in a girl presenting with mutism

Adrenocortical tumors (ACT) are rare tumors of childhood. There are some difficulties in classification of pediatric ACT as adenoma or carcinoma. Prognostic characteristics as well as treatment choices are controversial. In general virilizing ACT are presenting at earlier age than non-functional tumors. Here we presented an early presented, delayed diagnosed giant virilizing adrenocortical tumor in a girl presented with mutism. Present case is interesting both in complaints at the presentation and the nature of tumor biology. Based on previously reported prognostic criteria present case had borderline characteristics and treatment option was only total resection of the tumor without adjuvant chemotherapy.