Heart failure in a 10-year-old girl: incidental discovery of adrenal adenoma by cardiac MRI-case report.

BACKGROUND

Functional adrenal adenoma is uncommon in children, and cardiovascular complications, such as dilated cardiomyopathy and heart failure (HF), are rare as initial manifestations.

CASE SUMMARY: Here, we report a 10-year-old girl presenting with acute HF, mild troponin rise and severe left ventricular dysfunction in echocardiography. The Cardiac magnetic resonance imaging (CMR) demonstrated dilated cardiomyopathy, with a left ventricular ejection fraction (LVEF) of 17% with concentric left ventricular hypertrophy and a focal myocardial infarction. Extracardiac findings in CMR showed an incidental 3-cm right adrenal mass, and subsequent dedicated MRI with adrenal protocol showed features of a benign adenoma. Laboratory findings showed mixed Cushing's and hyperaldosteronism suggestive of a functional adrenal adenoma. The radical right adrenalectomy was performed, and pathology confirmed the diagnosis.

DISCUSSION: In the 1-year follow-up echocardiography, the LVEF was back to normal (55%), highlighting the reversible nature of cardiomyopathy in this condition.