The patient presented with hirsutism, central obesity, and striae rubrae. Blood pressure was at 180/110 mm Hg. Blood cortisol levels were elevated and ACTH suppressed. There was a palpable mass in the right upper and middle abdomen.
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Fig. 1Coronal HASTE showing a centrally necrotic tumour displacing the right kidney and its hilum caudally
MRI showed a massive tumour between the liver and right kidney, that was displaced caudally (Fig. 1). After contrast, the tumour showed heterogeneous enhancement with a large central necrosis (Fig. 2).