A 36-year-old non-smoker, chronic alcoholic female presented with recurrent episodes of epigastric pain and vomiting in the last 10 days. H/o similar episodes of pain 3 times, with last episode was noted 2 months back. She also had history of vomiting (3 episodes). Jaundice/melena/steatorrheas was not observed. Subsequently, contrast-enhanced computed tomography (CECT) of the patient was done and it showed well defined multiple cystic lesions with peripheral wall enhancement involving head and body of pancreas, largest measuring 24 X 22 X 22 mm in the head of the pancreas, the lesion was seen abutting antro-pyloric region anteriorly. Main pancreatic is mildly dilated measuring 4 mm in diameter. A well-defined heterogeneously hypodense (necrotic) para duodenal lesion, was noted inferior to uncinate process, m/s 22 X 20 X 20 mm, which is indicative of lymph nodal deposit. On magnetic resonance cholangiopancreatography (MRCP): few cystic lesions were seen scattered in the pancreatic parenchyma, with one of the cysts showing communication with main pancreatic duct (MPD) ab.

BACKGROUND: Tumors of the adrenal gland are extremely rare in children. Those of the adrenal cortex account for only 0.3-0.4 % of all childhood neoplasms. Its rarity has hindered the identification of meaningful prognostic factors. Because very few children have been treated for adrenal tumors, even at major cancer centers, clinical experience is relatively limited and optimal therapy has not been established. Even though assessment of malignancy through histological criteria has been controversial, several investigators reported high degree of accuracy in the evaluation of malignancy by microscopic examination (1,2) . Furthermore, Bugg et al reported that histological type and tumour weight were the most reliable predictors of tumour behaviour in the paediatric age group. AIM: To analyze various adrenal tumors based on histopathological pattern and correlate with clinical findings. MATERIALS AND METHODS:The study included 12 surgical specimens of adrenal gland out of which 3 were resected and 9 were biopsied specimens, collected between JULY 2006 to JUNE 2011 at Institute of Child Health, Niloufer hospital , Hyderabad. Tissues were processed and histopathological patterns were studied on Hematoxylin and Eosin stained sections. Immuno histochemistry was done in relevant cases and the markers used were Ki-67, Synaptophysin, NSE, Chromogranin. RESULT: The study showed incidence of 75% in male and 25% in female children with predilection towards left adrenal gland.