Adenomatoid tumor of the adrenal gland with micronodular adrenal cortical hyperplasia.

We report a case of an adenomatoid tumor (AT) of an adrenal gland with micronodular adrenal cortical hyperplasia (ACH). A 51-year-old man was found to have newly developed hypertension with clinical evidence of primary aldosteronism. A computerized tomogram of the abdomen revealed a solitary mass in the right adrenal gland. He underwent a right adrenalectomy for a presumptive clinical diagnosis of a solitary aldosterone-producing adrenal cortical adenoma. On histopathologic examination, the adrenal gland demonstrated an AT, diagnosed by the characteristic histological features, immunohistochemical stain results, and electron microscopic findings. The surrounding adrenal cortex showed multiple small hyperplastic cortical nodules. After the adrenalectomy, the patient's blood pressure normalized. Primary AT of the adrenal gland coexisting with micronodular ACH associated with hypertension has not been previously reported.

An unusual presentation of an aggressive spindle cell skin cancer.

Spindle cell squamous cell carcinoma (SCSCC) is a rare subtype of squamous cell carcinoma (SCC) that was first reported around 1900. Its potential for metastasis is uncertain. There has been noted a relationship to previous exposure to radiation therapy with subsequent aggressive presentation. We report an unusual case of a widely metastatic, poorly differentiated cutaneous spindle cell neoplasm with a rapidly progressive clinical course and dismal outcome in several days. This is one of a very few cases in the literature in which a skin cancer recurs with such diffuse metastasis and disastrous outcome.