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