title: Melanoma of unknown primary origin presenting as a rapidly enlarging adrenal mass.
abstract: Metastasis to the adrenal can be seen in the context of metastatic melanoma, but primary adrenal melanoma is very uncommon. We present a case of a rapidly enlarging adrenal mass that mimicked non-functioning primary adrenal malignancies but later proved to be part of a widely metastatic melanoma of unknown primary origin. Careful physical examination of the patient led to the discovery of a subcutaneous metastatic focus that was not seen on [(18)F]-fluorodeoxyglucose positron emission tomography/CT imaging. The presence of subcutaneous metastases raised the suspicion for metastatic melanoma; however, pathological confirmation remained the ultimate tool to reach the final diagnosis.
authors.affiliation: Department of Endocrine Neoplasia, MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Shamim
authors.initials: S
authors.lastname: Ejaz
authors.forename: Hassan
authors.initials: H
authors.lastname: Shawa
authors.forename: Samuel Alva
authors.initials: SA
authors.lastname: Henderson
authors.forename: Mouhammed Amir
authors.initials: MA
authors.lastname: Habra
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000556:secondary / Q000601:surgery; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008545:Melanoma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D009362:Neoplasm Metastasis; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D016634:Radiosurgery; D000077204:Temozolomide; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D003606:Dacarbazine; D000077204:Temozolomide