Adrenal myelolipoma

Q: What is the most likely diagnosis? show answer

A: Adrenal myelolipoma

Q: Considering a retroperitoneal fat-containing lesion, what could have been differential diagnosis? show answer

A: Retroperitoneal liposarcoma, fat-containing adrenal cortical carcinoma, renal angiomyolipoma, and teratoma, are fat containing lesions in this location.

Q: How does in- and out-of-phase imaging help in this condition? show answer

A: If the lesion contains intracellular lipid it will show characteristic signal loss on out-of-phase imaging as compared to in-phase. Many adrenal myelolipomas contain macroscopic fat, however, which will fat saturate, but not become hypointense on the out of phase sequence.