title: Pigmented "black" pheochromocytoma of the adrenal gland: a case report and review of the literature.
abstract: A pigmented "black" mass was discovered incidentally in a 72-year-old woman. The tumor, which was detected near the upper pole of the left kidney, was cystic and intensely black throughout with the presence of abundant, coarse, dark brown to black pigment granules. Histologic examination showed a proliferation of monomorphous neoplastic cells arranged in a typical zellballen growth pattern. These features indicated a diagnosis of pheochromocytoma. Immunostains for chromogranin A, synaptophysin, and neuron-specific enolase were positive. The immunostain for HMB-45 was negative. Electron microscopy showed neurosecretory-type granules and larger pleomorphic granules, which were considered most consistent with neuromelanin, a waste product of catecholamine metabolism. The evidence of melanin or melanin-like pigment in the adrenal gland has been described in only 10 cases in the literature and is always a microscopic finding. The case reported here is unique for the characteristic black macroscopic appearance and the abundance of pigment.
authors.affiliation: Institute of Pathological Anatomy and Histology, Division of Cancer Research, Perugia Medical School, University of Perugia, Italy. anapat1@unipg.it
authors.forename: Guido
authors.initials: G
authors.lastname: Bellezza
authors.forename: Michele
authors.initials: M
authors.lastname: Giansanti
authors.forename: Antonio
authors.initials: A
authors.lastname: Cavaliere
authors.forename: Angelo
authors.initials: A
authors.lastname: Sidoni
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis*; D000368:Aged; D005260:Female; D006801:Humans; D010673:Pheochromocytoma / Q000175:diagnosis*