case_images: PMC11368835_01
case_images: Timeline with data from course of care.
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case_images: Axial contrast enhanced CT (A) through the upper abdomen in November 2020 shows a 11 x 9.9 cm lobulated heterogeneously enhancing solid cystic mass in the left adrenal gland and a 4.6 x 3.4 cm similar appearing mass in the right adrenal gland (indicated by arrows). Coronal contrast enhanced CT (B) through the upper abdomen in November 2020 shows an intraluminal filling defect in the left renal vein consistent with thrombus associated with the left adrenal mass. A few suspicious lymph nodes are present in the vicinity.
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case_images: f2
case_images: An initial computed tomography (CT) scan of the abdomen and pelvis revealed heterogeneously enhancing solid mass lesions measuring 4.6 x 3.4 cm in the right adrenal gland and 11 x 9.9 cm in the left adrenal gland displacing the spleen and left kidney ( Figure 2 ).
case_images: PET-CT scan in June 2021 (A) shows residual uptake within the periphery of the left adrenal mass (arrow) with an SUV of 14.7. There was no significant metabolic activity in the right adrenal mass. PET-CT scan in January 2023 (B) shows enlargement of the left adrenal mass (arrow) which appears almost completely cystic with reduced volume and extent of metabolic uptake within the mass as compared to the previous PET-CT scan.
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case_images: f3
case_images: In January 2023 a whole-body positron emission tomography (PET)-CT scan was compared to a previous PET-CT scan from June 2021 ( Figure 3 ).
case_images: Axial contrast enhanced CT through the upper abdomen in June 2023 shows complete replacement of the left adrenal gland by a well circumscribed fluid attenuation mass with smooth margins measuring 9.9 x 7.9 x 7.8 cm. A linear area of fat attenuation is seen within the mass along the path of a previously placed pigtail catheter. There is a small left pleural effusion. The right adrenal mass has resolved, and the right adrenal gland appears normal.
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case_images: PMC11368835_01_fonc-14-1419827-g004.jpg
case_images: f4
case_images: A postoperative CT scan performed showed an ongoing left adrenal fluid attenuation mass measuring 9.9 x 7.9 x 7.8 cm, and a normal-appearing right adrenal gland ( Figure 4 ).