PMC5206842_01
Dextrocardia in the chest X-ray view
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F1
The plain chest X-ray showed no abnormalities except dextrocardia [Figure 1].
(a) Computed tomography scan of the upper abdomen. The red arrow indicates the adrenal tumour. (b) Increased fluorodeoxyglucose uptake in the right adrenal
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F2
Abdominal computed tomography of the upper abdomen also confirmed situs inversus and revealed a regular and homogenous solid tumour in the right adrenal gland, measuring 18 mm x 20 mm [Figure 2a]. A 18F-fluorodeoxyglucose (F18-FDG) positron emission tomography study was performed to further characterisation of the lesion which showed an increased FDG uptake, especially in the late sequences [Figure 2b].
(a) View of the adrenal mass, after the adhesions dissected between spleen and omentum. (b) The adrenal vein after dissection of surrounding soft tissues
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F3
The spleen and pancreatic tail are then rotated medially [Figure 3a]. The adrenal vein was divided after double clipping, and an adrenal tumour 30 mm x 20 mm x 18 mm in diameter was resected [Figure 3b].