Nonetheless, a previous study from southernand southeastern Brazil reported a high incidence of adrenocortical tumors inchildren, 10-15 times greater than the global incidence (32,33), with germline TP53 mutations present in50%-65% of cases (34).International data indicate that children typically present with the diseasewithin the first 5 years of life, with a strong female predominance and almostuniversal virilization (35).However, in the 1-4 year age group, the female-to-male sex ratio was lower thanpreviously reported (1.25:1 versus 1.6:1) (32). This evidence concerns the gene TP53 and adrenal cortex neoplasm.