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case_images: Pigmented skin and mucosal spots on the lips, oral mucosa, fingers and toes.
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case_images: She also had many spotty skin and mucosal pigmentation on her lips, oral mucosa, fingers, and toes (Figure 1).
case_images: Adrenal CT shows 2.3x1.7 cm sized well defined homogenous mass in the left adrenal gland.
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case_images: A 2.3x1.7 cm-sized well defined homogenous mass was seen in the left adrenal gland (Figure 2).
case_images: Magnetic resonance imaging shows focal low signal intensity lesion in right inferior portion of pituitary gland.
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case_images: However, there was a microadenoma in the inferior portion of the right pituitary gland (Figure 3).
case_images: The cut surface of surgical specimen shows golden yellowish colored dominant nodule with multiple black pigmented small nodules.
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case_images: Left adrenalectomy was performed, and the cut surface of the surgical specimen showed a golden yellowish colored dominant nodule with multiple black pigmented small nodules (Figure 4).
case_images: Microscopic finding shows cortical nodules composed of eosinophilic cells containing large bizzare nuclei and abundant acidophilic cytoplasm. The nodules are circumscribed but not encapsulated (A). Extracapsular nodules are noted at periadrenal fat. Abundant lipofuscin pigments are noted at tumor cytoplasma (B), (H&E stain, x200).
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case_images: On microscopic findings, variable multiple cortical nodules were noted and extracapsular nodules were also noted at periadrenal fat and abundant lipofuscin pigments were noted at the tumor cytoplasm (Figure 5).
case_images: The ultrasonographic finding of breast shows multiple benign appearing hypoechoic masses in both breasts.
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case_images: Ultrasonography of the thyroid showed a 0.3 cm sized hypoechoic nodule at the right thyroid, while ultrasonography of the breasts showed multiple hypoechoic masses on both breasts (Figure 6).