70-year-old male patient with history of left RCC now with right adrenal recurrence. Assess for IVC involvement. ABDOMEN:LIVER, BILIARY TRACT: There are scattered subcentimeter foci of arterial enhancement within the liver which do not demonstrate washout on more delayed images and may be perfusional in etiology (image 101 and 108, series 11). No suspicious hepatic lesions are identified. The hepatic veins and portal veins are patent.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: A normal right adrenal gland is not identified. There is a 5.8 x 6.5 cm mass within the right adrenal gland which demonstrates heterogeneous peripheral enhancement, central low intensity, and numerous enhancing septations on post-contrast images.The left adrenal gland is absent. KIDNEYS, URETERS: The left kidney is absent. There is no suspicious mass in the right kidney. The right kidney is enlarged, likely secondary to hypertrophy. There is the suggestion of two right renal veins with appear patent. RETROPERITONEUM, LYMPH NODES: There is mass effect along the right aspect of the infrahepatic inferior vena cava secondary to a large right adrenal mass. The IVC appears to opacify normally with contrast. A fat plane is delineated between a majority of the mass and the IVC. There is no definite direct invasion of tumor within the IVC. BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
Centrally necrotic right suprarenal mass, compatible with an adrenal metastasis given history, without definite extension into the IVC.