CASE 74 A 70-year-old man with a history of right nephrectomy for renal cell carcinoma comes for restaging of a malignancy. Fig. 74.1 (A) Axial noncontrast CT image in a 70-year-old man with a history of nephrectomy for renal cell carcinoma shows a well-defined, isodense left adrenal mass lesion (arrow). (B) Axial fat-saturated T2-weighted image in the same patient shows the lesion to be hyperintense. (C) On T1-weighted out-of-phase gradient echo imaging, the lesion shows no drop in signal intensity. (D) Axial contrast-enhanced T1-weighted imaging in the same patient shows intense enhancement of the lesion on an early arterial phase scan. Axial computed tomography (CT) and magnetic resonance (MR) images show a left adrenal mass that appears isointense on T1-weighted imaging, moderately hyperintense on T2-weighted imaging, does not show a drop in signal intensity on out-of-phase spoiled gradient echo images, and shows intense enhancement on contrast administration (Fig. 74.1). Metastatic renal cell carcinoma to the left adrenal gland
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