Melanoma of unknown primary origin presenting as a rapidly enlarging adrenal mass

BMJ Case Rep. 2013 Jun 19:2013:bcr2013009727. doi: 10.1136/bcr-2013-009727.

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.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms / diagnosis*
  • Adrenal Gland Neoplasms / drug therapy
  • Adrenal Gland Neoplasms / pathology
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Brain Neoplasms / secondary
  • Brain Neoplasms / surgery
  • Combined Modality Therapy
  • Dacarbazine / analogs & derivatives
  • Dacarbazine / therapeutic use
  • Diagnosis, Differential
  • Female
  • Humans
  • Melanoma / diagnosis*
  • Melanoma / drug therapy
  • Melanoma / pathology
  • Neoplasm Metastasis
  • Neoplasms, Unknown Primary / diagnosis*
  • Neoplasms, Unknown Primary / drug therapy
  • Neoplasms, Unknown Primary / pathology
  • Radiosurgery
  • Temozolomide
  • Tomography, X-Ray Computed

Substances

  • Antineoplastic Agents
  • Dacarbazine
  • Temozolomide