ren oc ort ical ▁car cin oma . ▁ ▁Sign s ▁and ▁sympt oms ▁ ▁Ad ren oc ort ical ▁car cin oma ▁may ▁present ▁differently ▁in ▁children ▁and ▁adult s . ▁Most ▁tum ors ▁in ▁children ▁are ▁functional , ▁and ▁vir il ization ▁is ▁by ▁far ▁the ▁most ▁common ▁present ing ▁sympt om ( s ), ▁followed ▁by ▁C ushing ' s ▁synd rome ▁and ▁pre co cious ▁pub ert y . ▁Among ▁adult s ▁present ing ▁with ▁h orm onal ▁synd rom es , ▁C ushing ' s ▁synd rome ▁alone ▁is ▁most ▁common , ▁followed ▁by ▁mixed ▁C ushing ' s ▁and ▁vir il ization ▁( gl uc oc ort ico id ▁and ▁and ro gen ▁over production ). ▁Fem in ization ▁and ▁Con n ▁synd rome ▁( min eral oc ort ico id ▁excess ) ▁occur ▁in ▁less ▁than ▁ 1 0 % ▁of ▁cases . ▁R are ly , ▁p he och rom oc yt oma - like ▁hyper secret ion ▁of ▁c ate ch ol am ines ▁has ▁been ▁reported ▁in ▁ad ren oc ort ical ▁can cers . ▁Non function al ▁tum ors ▁( about ▁ 4 0 %, ▁authorities ▁vary ) ▁usually ▁present ▁with ▁ab dom inal ▁or ▁fl ank ▁pain , ▁var ico ce le , ▁and ▁ren al ▁ve in ▁th rom b osis ▁or ▁they ▁may ▁be ▁asympt om atic ▁and ▁detected ▁incident ally . ▁ ▁All ▁patients ▁with ▁sus pected ▁A CC ▁should ▁be ▁carefully ▁evaluated ▁for ▁signs ▁and ▁sympt oms