Childhood Adrenocortical Tumors

摘要: The problem From 1966 ‐1996, 73 children under 16 yr of age with adrenocortical tumor were admitted to the Division Pediatric Endocrinology at Clinics Hospital, Federal University Parana, in city Curitiba, State southern Brazil. Hospital is a tertiary referral center for approximately 10 million inhabitants, 3.5 whom are less than 15 age. With 12‐14 new cases childhood (ACT) diagnosed Parana each year, annual incidence ACT within this region can be estimated range from 3.4 ‐ 4.2/ below yr. Remarkably, patients 4 or account vast majority seen (Fig. 1). This finding as well those other Brazilian states suggest an increased (1). By comparison, worldwide ranges only 0.3‐ 0.38/million (2, 3). Definitive explanations apparent excess Brazil presently lacking. located Tropic Capricorn and has no known endemic transmissible diseases. population mainly European extraction (Italy, Poland, Germany), locales which not been unduly increased. Moreover, compared regions Brazil, state had least native Indian influence during colonization. A genetic predisposition toward cancer, appears play role many tumors, common feature among families (4). Industrial pollutants, major contributor rates solid development, cannot accorded more minor due slow pace industrial expansion region. However, because extensive agricultural activities it possible that environmental such pesticides, may pose substantial health hazard. Agricultural pesticides widely used usually without safety guidelines. In regard, British investigators found association between pesticide use northwestern England (5), whereas Norway, Kristensen et al. (6) noted almost 2-fold increase relative risk cancer 0 whose parents engaged agriculture. Taken together, these findings pollutants causative excessive