PMC4564071_01
A 52-year-old lady with primary hyperaldosteronism due to adrenal cortical carcinoma. Abdominal ultrasound shows a large heterogeneous suprarenal mass (white arrow) (A) with vascularity within (B) on Doppler, which proved to be an adrenal cortical carcinoma on histopathology. Note the associated medullary nephrocalcinosis (black arrowheads).
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A screening abdominal ultrasound revealed a heterogeneous hypoechoic left suprarenal mass with vascularity within (Figure 1A, 1B). Increased diffuse hyperechogenicity without shadowing was also noted in the region of the renal pyramids (Figure 1A, 1B) suggestive of medullary nephrocalcinosis.
PMC4564071_02
A 28-year-old female with primary hyperaldosteronism and associated medullary nephrocalcinosis. Unenhanced CT scan of the abdomen, coronal reformatted image, shows bilateral adrenal hyperplasia (white arrows) and associated bilateral medullary nephrocalcinosis (black arrowheads).
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Incidentally, associated bilateral medullary nephrocalcinosis was also noted (Figure 2).
PMC4564071_03
A 61-year-old lady with a paraneoplastic syndrome due to a renin- secreting pulmonary carcinoid with subsequent secondary hyperaldosteronism, hypokalemia and associated nephrocalcinosis. Axial CT of the chest, unenhanced (A) shows a nodular mass lesion (white arrow) with calcification in the left main bronchus which showed homogenous intense enhancement on contrast administration (B). Also noted, post- biopsy hydropneumothorax and intercostal drain in situ.
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A chest x-ray demonstrated an ill-defined opacity in the left lower zone and a CT scan of the chest confirmed the presence of a nodular mass lesion with calcification in the left main bronchus which showed homogenous intense enhancement on contrast administration (Figure 3A, 3B).
A 61-year-old lady with a paraneoplastic syndrome due to a renin- secreting pulmonary carcinoid with subsequent secondary hyperaldosteronism, hypokalemia and associated nephrocalcinosis. CT abdomen, unenhanced, coronal sections, of the same patient shows the presence of medullary nephrocalcinosis in bilateral kidneys (black arrowheads).
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CT of the abdomen showed the presence of medullary nephrocalcinosis (Figure 4).
PMC4564071_04
A 22-year-old male with unusual association of nephrocalcinosis with hyperaldosteronism in a case of CAH due to 11beta-hydroxylase deficiency. Testicular adrenal cell rests seen on a scrotal ultrasound as multiple hypoechoic areas in bilateral testes (white arrowheads) with marked vascularity on Doppler.
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S crotal ultrasound was performed which revealed multiple hypoechoic areas in both testes which showed marked vascularity on Doppler examination (Figure 5).
A 22-year-old male with unusual association of nephrocalcinosis with hyperaldosteronism in a case of CAH due to 11beta-hydroxylase deficiency. An abdominal ultrasound of the same patient demonstrated bilateral hyperechoic medullary renal pyramids (black arrowheads) suggestive of nephrocalcinosis.
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An abdominal ultrasound was performed, which showed hyperechoic foci in bilateral renal medullary pyramids (Figure 6) suggestive of medullary nephrocalcinosis.
PMC4564071_05
A 17-year-old male with incidentally diagnosed medullary nephrocalcinosis in a case of CAH due to 11beta-hydroxylase deficiency with testicular adrenal cell rests. An abdominal ultrasound, showing hyperechoic foci in bilateral renal medullary pyramids suggestive of medullary nephrocalcinosis (black arrowheads). Note the associated enlarged adrenal (white arrow) as expected in congenital adrenal hyperplasia.
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A screening abdominal ultrasound showed bilateral medullary nephrocalcinosis with enlarged adrenals (Figure 7).
A 17-year-old male with incidentally diagnosed medullary nephrocalcinosis in a case of CAH due to 11beta-hydroxylase deficiency with testicular adrenal cell rests. Scrotal ultrasound shows multiple multiple hypoechoic areas in both testes with marked vascularity on Doppler examination suggestive of congenital adrenal cell rests.
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A scrotal ultrasound was performed in view of macroorchidism and showed presence of multiple hypoechoeic lesions with increased vascularity throughout both testicular parenchymas indicative of testicular adrenal cell rests (Figure 8).
A 17-year-old male with incidentally diagnosed medullary nephrocalcinosis in a case of CAH due to 11beta-hydroxylase deficiency with testicular adrenal cell rests. Axial CT scan of the same patient shows bilaterally enlarged adrenals (A) and enlarged testes showing intense contrast enhancement suggestive of testicular adrenal rest cells (B) consistent with congenital adrenal hyperplasia.
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The CT scan of the abdomen showed bilaterally enlarged adrenals (Figure 9A) and confirmed the presence of testicular masses (Figure 9B).