title: Adrenal black adenoma associated with Cushing's syndrome.
abstract: We report a case of adrenal black adenoma associated with Cushing's syndrome. A 41-yr-old man presented to our hospital with a 6-yr history of severe hypertension and general fatigue, and a 1-mo history of diabetes mellitus. Physical examination disclosed cushing-oid manifestations. His serum cortisol concentrations ranged from 14.0 to 15.4 microg/dL, with an ACTH level <5 pg/mL. Urinary free cortisol level was increased (125 microg/d). Cortisol was not suppressed on the overnight 1 mg oral dexamethasone suppression test (DST), 2-d low-dose DST, and 2-d high-dose DST. Abdominal computed tomography and magnetic resonance imaging studies revealed a solid round tumor approx 3 cm in diameter, located in the left adrenal gland. Left adrenalectomy was performed; the surgical specimen revealed a black ade-noma consisting of compact cells within numerous pigments that seemed to be lipofuscin in nature.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Karadeniz Technical University Faculty of Medicine Trabzon, Turkey. cihangirerem@hotmail.com
authors.forename: Cihangir
authors.initials: C
authors.lastname: Erem
authors.forename: Arif
authors.initials: A
authors.lastname: Hacihasanoglu
authors.forename: Akif
authors.initials: A
authors.lastname: Cinel
authors.forename: Umit
authors.initials: U
authors.lastname: Cobanoglu
authors.forename: Halil Onder
authors.initials: HO
authors.lastname: Ersöz
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmetoglu
authors.forename: Kubilay
authors.initials: K
authors.lastname: Ukinç
authors.forename: Mustafa
authors.initials: M
authors.lastname: Koçak
mesh_terms: D000302:Adrenal Cortex / Q000737:chemistry / Q000473:pathology; D000310:Adrenal Gland Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D018246:Adrenocortical Adenoma / Q000737:chemistry / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D003480:Cushing Syndrome / Q000209:etiology* / Q000601:surgery; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D006973:Hypertension / Q000209:etiology / Q000473:pathology; D008062:Lipofuscin / Q000032:analysis; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D008062:Lipofuscin; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone