PMC9124792_01
CT scan + contrast-enhanced ultrasound + 3D of adrenal gland revealed a spherical mass arising from the right adrenal gland with mixed density that was suspected to malignant tumor, a solid with multiple high-density nodules [(A), red arrow], some cystic-like lesions [(B), red *], and fat density shadows [(C), blue *], and no obvious enhancement signals (B, C). Other abdominal structures were normal and there was no evidence of distant metastasis although the right kidney was slightly displaced by the mass.
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The tumor was suspected to be a teratoma in the right adrenal gland area ( Figures 1A-C ).
CT scan of blood vessels: No abnormalities in bilateral renal arteries were discovered in CT imaging of renal arteries. A part of inferior vena cava below the lower border of the liver segment is confined by the mass of the right adrenal gland, and the venous lumen is a local stenosis; different layers show that the vena cava is compressed, including transverse [(A), arrow], coronal [(B), arrow], and sagittal planes [(C), arrow].
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No abnormalities in bilateral renal arteries were discovered in the CT image of renal arteries, and the inferior vena cava below the lower border of the liver was compressed by the mass of the right adrenal gland, resulting in localized stenosis of the vena cava ( Figures 2A-C ).
Pathological features of adrenal teratoma: (A) shows the gross appearance of the adrenal teratoma; the size was about 9 cm x 7 cm x 7 cm, and its envelope is intact. The cut surface is gray-yellow, namely, adipose tissue [(B), blue *], cystic solid, gray necrotic fluid [(B), red *], and sebum were found in part of the cyst cavity (B). H&E stain, 10x (C).
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The size of gross tumor was about 9 cm x 7 cm x 7 cm, and its envelope was intact ( Figure 3A ). The cut surface was gray-yellow and cystic solid with gray necrotic fluid, and sebum and hair were found in part of the cyst cavity ( Figure 3B ). The tumor of right adrenal gland was diagnosed as a mature teratoma by pathologists ( Figure 3C ); therefore, we did not do any further genetic diagnosis.