ABSTRACT
Primary neoplasms of the adrenal cortex are rare in children and differ from their counterparts in term of clinical characteristics. The studies revealed that prognosis of these tumors are not as bad as previous expectation. Differentiation between adenoma and carcinoma adrenal tumors in the absence of metastasis to other organs is impossible. The survival of the patients depends on the age, being longer in children under 5 years old The utilization of imaging surveys particularly CT scan and MRI facilitated the investigation of the children with early puberty and Cushing 's syndrome. However a combination of clinical finding and imaging methods is required. the patient was a 4.5 months old infant with Cushing's syndrome who presented with generalized edema. She was suspected to have adrenocortical neoplasm and subjected to the operation of left side adrenalectomy. The diagnosis was confirmed by pathological examination of the patient biopsy