• Collect demographic/medical information, detailed family history of cancer of children/adolescents with adrenocortical tumors, learn more about the clinical and epidemiological aspects, treatment modalities, and outcome of patients [ Time Frame: Indefinite ] [ Designated as safety issue: No ]
  

• To store adrenocortical tumor tissue (tumor banking) for molecular studies aimed to clarify the role of the P53 gene and other genetic pathways in these tumors. [ Time Frame: Indefinite ] [ Designated as safety issue: No ]
  
• To obtain a peripheral blood sample (3-5 mL) from patients and relatives for determination of the P53 germline status [ Time Frame: Indefinite ] [ Designated as safety issue: No ]
  
• To obtain tumor tissue (of any histology) from patients and relatives for molecular studies of the P53 gene and other genetic pathways in these individuals. [ Time Frame: Indefinite ] [ Designated as safety issue: No ]
  

Adrenocortical tumors (ACT) are very rare in children and teenagers. Of all the new cases of cancer diagnosed each year in the United States and Europe in patients younger than 20 years old, only about 0.2% are ACT. Studies from several laboratories including St. Jude Children's Research Hospital have revealed that the majority of children with ACT, particularly those younger than 4 years of age, have constitutional P53 mutations. Some mutations, as exemplified by the R337H P53 germline mutation, in which the function of the mutant protein is relatively preserved, the history of cancer in the carriers and their families is relatively unremarkable. In other cases, the P53 mutated gene encodes a functionally-impaired protein that predicts for a pervasive history of familial cancer (Li-Fraumeni syndrome). Therefore, these observations have implications for genetic counseling of families with childhood ACT and underscore the importance of genotype-phenotype correlations in familial cancer syndromes.

The creation of a specific rare tumor registry provides a mechanism to collect information that cannot be gathered in a single institution. The analysis of the registry data would permit an overview of the clinical, epidemiological, current treatment standards, and survival data of these patients and thus create opportunities for research. It also may facilitate the development of treatment consensus among investigators who register their patients and help to design future studies. Moreover, the combined COG and IPACTR studies are expected to provide meaningful insight into the biology of ACT, including clinical phenotype/genotype relationships, treatment outcome and long-term follow-up data in subjects with this rare tumor. Finally, it would provide data on the long-term consequences of exposure to tumor-secreted androgens (found in more than 80% of the pediatric cases) on children's growth and development.