Dandy-Walker Malformation (DWM) and Pilocytic Astrocitoma are both rare disease entities that typically manifest early in life are associated with congenital etiological factors. DWM is a cerebellar malformation associated with a series of anatomical changes.The disease onset is usually at bith or during infancy. Late onset in adulthood is uncommon., Pilocytic astrocytoma is a tumor that arises from glial cells, primarily astrocytes, and is classified as grade I by the WHO. It is typically diagnosed in children and is frequently found in the posterior fossa. Concomitant occurrence of DWM and Pilocytic Astrocytoma there are very few reported cases.

Primary adrenal melanoma (PAM) is a rare malignant tumor, with few reported cases in the published literature and often correlated with high mortality rates. This condition usually has an unclear clinical presentation and must have its differential diagnosis regarding metastatic processes from malignant melanoma and pigmented pheochromocytoma. In this article, we report a case of a 49-year-old male diagnosed with PAM, alongside with its progress and discussions about the diagnostic criteria established, willing to expand and disseminate knowledge and awareness about PAM [1].