Adrenal metastasis from colorectal cancer
Known case of colorectal cancer. Now right upper quadrant pain
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Very large, predominately cystic mass in the right adrenal (ie above and separate from the right kidney, compressing the right hepatic lobe). No hyperdensity to indicate recent haemorrhage. Pain is either due to pressure effects on adjacent organs or central necrosis and infarction. No hepatic metastases. Only other site of metastsis is the fat of the left buttock where there is a large mixed solid and cystic mass lesion (arrow).
The adrenal is a very unusual site for colorectal metastasis and the cystic nature of the lesion is also very unusual.