Adrenal cortical carcinoma
Incidental finding on ultrasound exam.
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The MRI sequences demonstrate a large well-defined left suprarenal mass measuring (13 x 11 x 9.5 cm) of low signal on T1WI, intermediate to high signal on T2WI with central areas of high signal (necrosis), and restricted diffusion on DWI/ADC. The post contrast sequences show moderate, and heterogeneous enhancement. A mass effect is note on the adjacent structures with upward displacement of the spleen, downward displacement of the kidney, and anterior displacement of the corporeocaudal segment of the pancreas. Note focal extension (thrombus) into the ipsilateral renal vein. The IVC is patent with no regional lymph nodes seen.
MRI features are most consistent of adrenal cortical carcinoma.