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Adrenal Myelolipoma in a Patient With Metastatic Neuroendocrine Tumor: The CT Finding That Prevents a False Diagnosis of Adrenal Metastasis

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Edited by ScholarGen MediAI Team Executive Answer An adrenal mass in a patient with known metastatic malignancy is not automatically an adrenal metastasis. In this case, a well-defined left adrenal mass measured approximately −59 HU on CT , strongly indicating macroscopic fat. MRI further demonstrated persistent high signal on in-phase and out-of-phase images with signal suppression on fat-suppressed sequences, supporting macroscopic rather than intracellular lipid. Diffusion-weighted imaging showed no definite restriction, and the lesion demonstrated no significant uptake on Cu-64 DOTATATE PET/CT. Taken together, these findings support adrenal myelolipoma , a benign fat-containing adrenal tumor, rather than metastatic neuroendocrine tumor. Why This Case Matters An adrenal mass can become diagnostically difficult when it appears in a patient who already has proven malignancy. The clinical context can create a powerful assumption: Known cancer + new adrenal mass = adrenal metastasis. Th...
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Renal Cell Carcinoma on MRI: A 6.6-cm Renal Mass With Microscopic Fat, Hypervascular Enhancement, Restricted Diffusion, and Reduced FA

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  Edited by ScholarGen MediAI Team A Multiparametric MRI Case Study of a Complex Renal Mass A renal mass discovered during a routine examination can present a deceptively simple question: Is this lesion benign or malignant? In practice, the answer rarely comes from a single MRI sequence. A modern renal mass evaluation integrates morphology, enhancement, chemical-shift imaging, diffusion characteristics, quantitative ADC measurements, and, in selected research settings, diffusion tensor imaging (DTI) and fractional anisotropy (FA). This case demonstrates how these imaging features can converge into a coherent radiologic phenotype suggestive of renal cell carcinoma (RCC), particularly a clear cell phenotype. The lesion measured approximately 59 × 66 × 57 mm , with a maximum diameter of about 6.6 cm , and was located in the interpolar-to-lower pole region of the left kidney. The most important imaging combination was: Microscopic fat + avid arterial enhancement + early wash-in + delay...
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