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Adrenal cortical carcinoma

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Left upper abdominal pain with a palpable mass.

Patient Data

Age: 45 years
Gender: Male
mri

Large relatively well-circumscribed lobulated retroperitoneal soft tissue mass of left suprarenal location. It displays a low signal on T1, intermediate to high signal on T2 and T2 fat sat with heterogeneous enhancement and restricted diffusion of the solid non-necrotic component. Numerous retroperitoneal satellite nodules show of same signal intensity and enhancement with infiltration of the perinephric fat and thickening of the perirenal fascias. A mass effect is noted on the corporeocaudal segment of the pancreas and renal vein which are displaced anteriorly as well as the left kidney which is displaced inferiorly.

Small celiac lymphadenopathy is noted.

Small hepatic hemangiomas (the largest is located in segment 4) are noted as well as tiny simple hepatic cysts.

Case Discussion

MRI features of a large retroperitoneal soft tissue mass of suprarenal location with adjacent retroperitoneal satellite nodules.

The patient went to have a resection of the mass with a histopathological exam that confirms the diagnosis of adrenal cortical carcinoma.

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