PMC3913141_01
Magnetic resonance imaging. Right adrenal mass
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In magnetic resonance imaging (MRI) of adrenal glands with IV contrast, a mass measuring 53x25x46 mm in size at the posterior aspect of inferior vena cava and medial side of liver just above right adrenal gland confirmed an adrenal gland tumor (Fig.1).
Adrenal tumor relapse with liver involvement.
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These findings indicated relapse of the removed adrenal tumor (Fig. 2).
Capsular invasion is seen by neoplastic adrenocortical cells
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Capsular invasion), this neoplasm had five of nine criteria which was compatible with adrenal cortical carcinoma (Fig. 3 and Fig. 4).
Hepatic tissue infiltrated by neoplastic adrenocortical cells
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Histopathologic assessment of second surgical specimens showed segmental lobectomy of right hepatic lobe (14x12x12 cm) and retroperitoneal mass resection (5x5x4 cm) also showed the same microscopic features of primary adrenal cortical tumor composed of large eosinophilic cells with highly atypical nuclei arranged in peritheliomatous and diffuse pattern with extensive necrosis (Fig. 5 and Fig. 6).