eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-06-08 9 10 492 494 10.12691/ajmcr-9-10-3 AJMCR20219103 article Kamyar Asadipooya 1 Roohollah Narimani 2 Ashraf Aminorroaya 2 Bijan Iraj? 2 Mohammadreza Kalantarhormozi m.kalantraihormozi111@yahoo.com 3 Novin Afshar Moghadam 4 Elaheh Kavoussi 4 Mitra Dashtizadeh??? 4 Division of Endocrinology and Molecular Medicine, Department of Medicine, University of Kentucky, Lexington, Kentucky Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Department of Internal Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, IRAN Department of pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IRAN Primary pigmented nodular adrenocortical disease (PPNAD) is a rare cause of Adrenocorticotropic hormone-independent Cushing syndrome. In this case, we present a case of PPNAD in 25 y/o women who presented with a 3 years history of weight gain, hirsutism, and abnormal menstruation. Our findings were suggestive of PPNAD in the pathological study of adrenal biopsy. http://pubs.sciepub.com/ajmcr/9/10/3/ajmcr-9-10-3.pdf Cushing syndrome PPNAD Primary pigmented nodular adrenocortical hirsutism low dose dexamethasone suppression test