Dig a Little Deeper: Adrenal

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Presentation transcript:

Dig a Little Deeper: Adrenal Andrew D Hardie, MD MUSC

Adrenal Protocol CT Noncontrast 34 HU

Adrenal Protocol CT Portal Venous Phase 76 HU

Adrenal Protocol CT 10 Minute washout 42 HU

Absolute = 72% Relative = 45% Interpreted as consistent with adenoma Washout Calculation Absolute = 72% Relative = 45% Interpreted as consistent with adenoma

What else was on the image?

Diagnosis Gastrointestinal Stromal Tumor (GIST) Metastatic to the adrenal gland

Learning Point - Hypervascular metastases can overlap - Adrenal protocol was designed to assess between HYPOvascular metastases and primary adrenal neoplasms (adenomas) which are usually HYPERvascular. - Hypervascular metastases can overlap - Choi et al. Evaluation of Adrenal Metastases from Renal Cell Carcinoma and Hepatocellular Carcinoma: Use of Delayed Contrast- enhanced CT. Radiology 2013 - Pheochromocytomas can overlap also