Primary melanoma of the adrenal gland, a continuous dilemma: report of a case.

The adrenal gland can frequently be the site of metastatic deposits, including malignant melanocytic tumors; however, primary melanoma of the adrenal gland is exceptional. We reviewed 18 cases reported in the English literature to date, and here add another case which occurred in a 78-year-old man. The patient underwent right suprarenalectomy and the pathology report showed a malignant melanoma of the adrenal gland. Immunohistochemical staining revealed a positive antibody-specific cytoplasmic reactivity to S-100 and HMB-45 proteins with a negative reaction for cytokeratin (AE1, AE3), synaptophysin, chromogranin and neuron-specific enolase. There are diagnostic criteria for accepting an adrenal melanoma as primary; however, an autopsy is the final step to confirm this infrequent pathology.