Authors: Geller, Jordan¹; Azer, Paul²; Weiss, Lawrence³; Mertens, Richard⁴

Source: Endocrine Pathology, Volume 17, Number 3, September 2006 , pp. 297-304(8)

Publisher: Humana Press

Abstract:

Darkly pigmented adrenocortical neoplasms are rare tumors that are often referred to as “black adenomas,” indicative of both their pigmented nature and their invariably benign clinical behavior in previously reported cases. We herein describe an exceptional case of a malignant pigmented adrenocortical neoplasm, with late recurrence and metastasis. At age 53, this female patient was diagnosed with Cushing's syndrome and underwent a laparoscopic right adrenalectomy, revealing a 3 cm well-circumscribed, darkly pigmented adrenocortical tumor. The tumor exhibited several atypical histologic features and was diagnosed as an atypical pigmented adrenal cortical neoplasm of uncertain malignant potential. Eight years later, the patient developed clinical and biochemical evidence of recurrent Cushing's syndrome, and imaging studies revealed the presence of several masses in the right retroperitoneum. At subsequent exploratory laparotomy, three separate tumor nodules exhibiting varying degrees of pigmentation and ranging from 2.2 to 3.3 cm maximum dimension were excised. Histologically, the tumor nodules were consistent with local recurrence/metastasis of the patient's previously excised pigmented adrenocortical neoplasm.

Keywords: Adrenal; pigmented adrenocortical carcinoma; black adenoma; differential diagnosis; late recurrence

Document Type: Research article

DOI: http://dx.doi.org/10.1385/EP:17:3:297

Affiliations: 1: Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center, 90048, Los Angeles, CA, Email: mertensr@cshs.org 2: Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center, 90048, Los Angeles, CA, 3: Division of Pathology, City of Hope National Medical Center, 91010, Duarte, CA, 4: Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Room 8746, 8700 Beverly Boulevard, 90048, Los Angeles, CA,

Publication date: 2006-09-01

Related content

• In this: publication
• By this: publisher
• In this Subject: Internal Medicine
• By this author: Geller, Jordan ;  Azer, Paul ;  Weiss, Lawrence ;  Mertens, Richard

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers