Malignant Melanoma, Adrenal Glands
Artur Rangel Filho, MD, PhD
Vania Nosé, MD, PhD
Key Facts
Terminology
Primary malignant neoplasm of adrenal gland
Clinical Issues
About 20 cases reported
Adrenalectomy and nephrectomy
Microscopic Pathology
Similar to melanoma arising in conventional sites
May be amelanotic
Ancillary Tests
Positive Immunostains: S100, melan-A, HMB-45
Negative Immunostains: Synaptophysin, chromogranin
Electron microscopy
Presence of melanosomes and premelanosomes
Diagnostic Checklist
Differentiate from pigmented pheochromocytomas
Exclusion of adrenal metastasis
 Primary adrenal melanoma is a highly cellular neoplasm composed by polygonal cells with irregular nuclei and abundant brown granular pigment (melanin)  . |
 H&E shows polygonal melanoma cells with admixed melanin pigment deposition  . Compressed adrenal cortical cells  are present within the fibrous bundles of the capsule. |
TERMINOLOGY
Abbreviations
Primary adrenal melanoma (PAM)
Synonyms
Primary malignant melanoma of adrenal gland
Definitions
Adrenal neoplasm of melanocytes
ETIOLOGY/PATHOGENESIS
Origin
Neural crest-derived cells in adrenal gland
