Adrenal cortical adenoma with excess black pigment deposition, combined with myelolipoma and clinical Cushing's syndrome.

Abstract

We report a case of a functional adenoma with excess black pigment deposition and myelolipoma in the same adrenal gland in a 58-year-old woman. The patient presented with gastrointestinal bleeding, and after being diagnosed with colonic diverticulosis, underwent a total colectomy. An abdominal computerized tomographic (CT) scan during her work-up showed a right adrenal mass consistent with myelolipoma. Postoperatively, the patient was diagnosed with Cushing's syndrome and underwent a right adrenalectomy. The adrenalectomy specimen consisted of a dark brown and golden-yellow adrenal adenoma, myelolipoma, and atrophic adrenal gland. Immunostains indicated that the dark brown adenoma component was responsible for the patient's hypercortisolism. Co-occurrence of a functional black adenoma and a well-developed myelolipoma has not been reported in the literature. We describe the significant findings of this case, together with a review of the literature.

• Authors: Ray Armand, Anne R Cappola, Richard B Horenstein, Cinthia B Drachenberg, Hironobu Sasano, John C Papadimitriou
• Journal: International journal of surgical pathology (Int J Surg Pathol) Vol. 12 Issue 1 Pg. 57-61 (Jan 2004) ISSN: 1066-8969 [Print] United States
• PMID: 14765276 (Publication Type: Case Reports, Journal Article)

Topics

• Adrenal Gland Neoplasms (complications, pathology, ultrastructure)
• Adrenalectomy
• Adrenocortical Adenoma (complications, pathology, ultrastructure)
• Colectomy
• Cushing Syndrome (etiology, surgery)
• Diverticulosis, Colonic (complications, surgery)
• Female
• Humans
• Immunohistochemistry
• Middle Aged
• Myelolipoma (complications, pathology, surgery, ultrastructure)
• Neoplasms, Multiple Primary (pathology, surgery, ultrastructure)
• Pigmentation