Male 58 years old Reason: eval (AD)renal mass History: eval (AD)renal mass ABDOMEN:LIVER, BILIARY TRACT: Liver is normal in morphology. Hepatic and portal veins are patent. No biliary ductal dilatation.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: There is a left adrenal mass which is heterogeneously T2 hyperintense measuring 4.2 x 3.7 cm that originates from the lateral limb of the left adrenal gland. The lesion has heterogeneous early contrast enhancement. There is slight infiltrative changes along the medial border of the lesion with the left renal vein and left crus of the diaphragm.KIDNEYS, URETERS: There are bilateral renal cysts. No hydronephrosis in either kidney. Left renal vein is collapsed limiting evaluation. No definite evidence of thrombus although the mass abuts the left renal vein and compresses it. Infiltration of tumor along into left renal vein wall is not excluded.RETROPERITONEUM, LYMPH NODES: There are multiple small left periaortic lymph nodes.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Postsurgical changes with lumbar hardware involving the lower lumbar spine.OTHER: No significant abnormality noted.
1.Findings of a 4.2 cm malignant-appearing left adrenal mass. Differential considerations include pheochromocytoma and possibly adrenocortical carcinoma.2.There is infiltration of the medial border of the mass as it abuts the left renal vein which is extrinsically compressed and early invasion is not entirely excluded. There is also loss of the fat plane between the adrenal mass and the left diaphragmatic crus.3.No specific evidence of metastatic disease in the upper abdomen although there are small left retroperitoneal lymph nodes in the region.