A rare pediatric case of Li-Fraumeni syndrome presenting with virilization symptoms and dual primary malignancies on magnetic resonance imaging and [18F]-fluorodeoxyglucose positron emission tomography/computed tomography

Pediatr Radiol. 2025 Nov;55(12):2671-2675. doi: 10.1007/s00247-025-06340-0. Epub 2025 Aug 15.

Abstract

This case report describes a 19-month-old boy presenting with macropenis, increased stature, and deep voice, who was diagnosed with concurrent choroid plexus carcinoma in the right lateral ventricle and left adrenocortical carcinoma. Subsequent germline testing revealed pathogenic TP53 mutations, confirming a diagnosis of Li-Fraumeni syndrome. Li-Fraumeni syndrome with primary manifestations of macropenis and accelerated linear growth has rarely been documented in the medical literature. This case highlights the critical importance of implementing whole-body imaging modalities in pediatric patients with growth-developmental abnormalities, particularly those suggestive of Li-Fraumeni syndrome, to guide therapeutic decision-making and follow-up monitoring.

Keywords: Adrenocortical carcinoma; Choroid plexus carcinoma; Li-Fraumeni syndrome; Magnetic resonance imaging; Positron emission tomography computed tomography.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Neoplasms* / diagnostic imaging
  • Adrenocortical Carcinoma* / diagnostic imaging
  • Carcinoma
  • Choroid Plexus Neoplasms* / complications
  • Choroid Plexus Neoplasms* / diagnostic imaging
  • Diagnosis, Differential
  • Fluorodeoxyglucose F18
  • Humans
  • Infant
  • Li-Fraumeni Syndrome* / complications
  • Li-Fraumeni Syndrome* / diagnostic imaging
  • Li-Fraumeni Syndrome* / genetics
  • Magnetic Resonance Imaging* / methods
  • Male
  • Neoplasms, Multiple Primary* / diagnostic imaging
  • Positron Emission Tomography Computed Tomography* / methods
  • Radiopharmaceuticals
  • Virilism* / diagnostic imaging
  • Virilism* / etiology

Substances

  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals

Supplementary concepts

  • Choroid Plexus Carcinoma