Case Series and Review of Literature of Malignant Adrenocortical Neoplasms: Experience of Two Tertiary Centers in Saudi Arabia.

Pediatric malignant adrenocortical neoplasms are among the rarest tumors encountered by pediatric surgeons and oncologists. In Saudi Arabia, only case reports exist due to the rarity of the condition. In this case series, we present five cases of malignant adrenocortical neoplasm and their clinical outcomes from two tertiary centers in Riyadh, Saudi Arabia, from 2012 to 2021. Patients ranged in age from one to eight years. We report the cases of three female and two male patients. All cases presented with hormonally active tumors. In two cases where tumors were excised with negative margins, only surgery and close follow-up were performed. In three cases, neoadjuvant and/or adjuvant therapy was required. In conclusion, for malignant adrenocortical neoplasms, the timing of diagnosis played a vital role in outcomes. Best outcome can be achieved with complete surgical excision as malignant adrenocortical neoplasms show a poor response to other treatment modalities.