Cushing's syndrome associated with functional black adenoma of the adrenal cortex

A 35-year-old woman who had bone pain in the extremities was found to have Cushing's syndrome, for which she had adrenalectomy. Pathologic examination revealed a solitary black adenoma. Bone scan and roentgenograms showed regional osteoporosis of the extremities and avascular necrosis of the hip. Her cushingoid manifestations and bone pain resolved after adrenalectomy and vitamin D therapy.