PMC7566197_01
Radiological findings. (a) Contrast-enhanced computed tomography showing a well-demarcated tumor with heterogeneously enhanced areas of density with extravasation of the contrast. (b) Magnetic resonance imaging showing iso-intensity to hyperintensity on T2-weighted imaging (b) and heterogeneity on T1-weighted imaging without fat component (c). (d) Angiography through the left renal artery showing extravasation (arrow) in the tumor, mainly from the left adrenal artery (arrow head). (e) Gallium scintigraphy showing no accumulation of contrast within the tumor.
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C-reactive protein (0.3 mg/dl) were not suggestive of inflammation. Contrast-enhanced CT revealed a well-defined tumor that was heterogeneously enhanced with extravasation of contrast at the left adrenal site, which also showed pancreatic tail and left kidney involvement (Fig. 1a). T2-weighted imaging and had heterogeneous intensity on T1-weighted imaging without fat components (Fig. 1b, c). Transcatheter angiography revealed extravasation in some parts of the tumor, mainly from the left adrenal artery (Fig. 1d). Gallium scintigraphy revealed no accumulation of contrast in the tumor (Fig. 1e).
Macroscopic and microscopic findings of resected specimen. The mass contained necrotic tissue and fibrin, a partially organized hematoma and fused with the left adrenal gland (arrow) (a). Histopathological findings showing a hematoma surrounded by fibrous tissues (b: x12.5, c: x200).
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The resected specimen was a tumor measuring 25 x 23 cm in diameter and composed mainly of necrotic tissue and fibrin, surrounded by a capsule and fused to the left adrenal gland (Fig. 2a). Histopathological findings revealed dense fibrous and necrotic connective tissue with old clots, and there was no evidence of viable cells (Fig. 2b, c).