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Primary melanoma of the adrenal gland: a case report and review of the literature

DOI: 10.1186/1752-1947-5-273

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Abstract:

We describe the case of a 58-year-old Caucasian woman who consulted her doctor with symptoms of asthenia, anorexia and weight loss. A mass was palpated in her abdomen at the height of the left hypochondrium. A computed tomographic scan revealed a retroperitoneal mass measuring 10 cm × 15 cm originating in the left adrenal gland. A left nephroadrenalectomy and splenectomy were performed. Histopathologically, the retroperitoneal mass corresponded to a melanoma, and no primary melanoma was found in any other location. The patient was treated with interferon-α-2b. Three years after her diagnosis the patient presented with a retroperitoneal relapse of the mass measuring 7.2 cm, which was removed. Five years after the first relapse a new retroperitoneal relapse mass was diagnosed, which was also removed. Since then the patient has been healthy and free from illness.Histological and immunohistochemical studies, together with the criteria described by Ainsworth et al. and Carstens et al., allowed us to diagnose primary melanoma of the adrenal gland.Primary melanoma of the adrenal gland is an exceptionally rare occurrence, as demonstrated by the few cases described in the medical literature [1-11]. Both primary and metastatic melanomas of the adrenal gland are rarely clinically evident, and in most cases they are incidental findings. Generally, the signs and symptoms that characterize these clinical entities are not at all specific, with pain being the most common manifestation, together with imprecise gastrointestinal disorders, caused by the compression of the structures adjacent to these neoplasias [12]. It is not unusual to come across the typical symptoms of any tumor process, such as asthenia, anorexia and weight loss.Primary melanoma of the adrenal gland is usually a voluminous, non-functional tumor showing heterogeneous contrast enhancement on the computed tomographic (CT) scan. The diagnosis is made on the basis of histological and immunohistochemical studies.The ad

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