MediAI

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...

  Introduction A 63-year-old woman arrives with abdominal pain, vomiting, and intermittent diarrhea. She has a history of diabetes, hypertension, and GERD. At first glance, this may appear to be common gastroenteritis, medication-related gastritis, or peptic ulcer disease. But advanced medical imaging , laboratory evaluation, and nuclear medicine reveal a much rarer cause: gastrinoma with local metastatic lymph node causing Zollinger-Ellison syndrome (ZES). This case highlights one of the most important truths in radiology interpretation and CT scan diagnosis : common symptoms can hide uncommon disease. Gastrinoma is a rare neuroendocrine tumor that secretes gastrin, causing uncontrolled gastric acid production. The result can be recurrent ulcers, severe diarrhea, intestinal inflammation, and life-threatening complications. Detecting these tumors requires high clinical suspicion and modern imaging such as contrast CT, MRI, endoscopy, and 68Ga-DOTATATE PET/CT . For clinicians...