Abstract:Objective: To analyze the ultrasonographic features and clinical presentations of adrenocortical carcinoma(ACC) in children. Methods: The ultrasonographic features of ACC in 16 cases were reviewed retrospectively. Results: The margins of tumors were well defined, 13 cases were hypoechoic with hyperechoic areas in 6 cases, 2 cases were hyperechoic, 1 case was medium echoic. The tumors had various level of cystic areas in 6 cases. The tumor extended into vessel or right atrium in 4 cases. Four cases had nonfunctioning ACC without clinical presentations. The clinical aspects included Cushing’s syndrome, virilization, hypertension. Conclusion: The tumor was hypoechoic and had tumor-embolism in some cases. It is not difficult to make correct diagnosis at the support of clinical aspects. Nonfunctioning ACC is large, but its ultrasonography had few feature, and the patient had no clinical presentations, so it is difficult to make correct diagnosis. It is necessary to discriminate with neurogenic tumor.