title: 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.affiliation: Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
authors.forename: Ray
authors.initials: R
authors.lastname: Armand
authors.forename: Anne R
authors.initials: AR
authors.lastname: Cappola
authors.forename: Richard B
authors.initials: RB
authors.lastname: Horenstein
authors.forename: Cinthia B
authors.initials: CB
authors.lastname: Drachenberg
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: John C
authors.initials: JC
authors.lastname: Papadimitriou
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000473:pathology* / Q000648:ultrastructure; D000315:Adrenalectomy; D018246:Adrenocortical Adenoma / Q000150:complications / Q000473:pathology* / Q000648:ultrastructure; D003082:Colectomy; D003480:Cushing Syndrome / Q000209:etiology* / Q000601:surgery; D043963:Diverticulosis, Colonic / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D018209:Myelolipoma / Q000150:complications / Q000473:pathology* / Q000601:surgery / Q000648:ultrastructure; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery / Q000648:ultrastructure; D010858:Pigmentation