Abstract
Precocious puberty is commonly observed in pediatric practice due to different causes, including adrenal tumors. Adrenocortical tumors are rare in children and are characterized by an androgenic hormonal excess that causes pseudo-precocious puberty. We present the case of a four-year-old boy with a history of penile enlargement associated with the growth of pubic hair, facial acne, and three-years advanced bone age. Based on hormonal assays, the diagnosis of pseudo-precocious puberty was confirmed. Abdominal magnetic resonance imaging (MRI) revealed a right-sided, retroperitoneal, well-defined adrenal tumor. This case report emphasizes the aim to increase the awareness of adrenocortical tumor as a rare cause of pseudo-precocious puberty in young children.