ABSTRACT
Hypercortisolism, or Cushing's syndrome, is the result of glucocorticoid excess caused by pituitary adenomas secreting adrenocorticotropic hormone (ACTH), adrenal tumours including carcinoma and adenoma, ectopic ACTH syndrome, nodular adrenal hyperplasia or ACTH-producing tumours. Thyroid nodules are uncommon in children but have a relatively high likelihood of associated cancer. In children, the incidence of malignancy in thyroid nodules is about 20%. This cancer rate is lower than has been reported in previous decades because fewer children today have been exposed to neck irradiation. Appropriate and prompt evaluation and management are important because the malignancy may be at an early, curable stage. Primary hyperparathyroidism in childhood usually results from a solitary hyper-functioning adenoma and more rarely from diffuse hyperplasia of all four glands. Persistant hyperinsulinaemic hypoglycaemia of infancy is the most common cause of persistent hypoglycaemia in infancy. The management of primary hyperparathyroidism in children is surgical.
