Adrenal black adenoma associated with Cushing's syndrome

Endocrine. 2004 Dec;25(3):253-7. doi: 10.1385/ENDO:25:3:253.


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.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex / chemistry
  • Adrenal Cortex / pathology
  • Adrenal Gland Neoplasms / chemistry
  • Adrenal Gland Neoplasms / complications
  • Adrenal Gland Neoplasms / diagnosis*
  • Adrenal Gland Neoplasms / surgery
  • Adrenocortical Adenoma / chemistry
  • Adrenocortical Adenoma / complications
  • Adrenocortical Adenoma / diagnosis*
  • Adrenocortical Adenoma / surgery
  • Adrenocorticotropic Hormone / blood
  • Adult
  • Cushing Syndrome / etiology*
  • Cushing Syndrome / surgery
  • Humans
  • Hydrocortisone / blood
  • Hydrocortisone / urine
  • Hypertension / etiology
  • Hypertension / pathology
  • Lipofuscin / analysis
  • Magnetic Resonance Imaging
  • Male
  • Tomography, X-Ray Computed
  • Treatment Outcome


  • Lipofuscin
  • Adrenocorticotropic Hormone
  • Hydrocortisone