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Special Feature |

Image of the Month—Quiz Case FREE

Lucy Connor; Joanna Craig; Kerri E. Buch, RN, FNP; Celia M. Divino, MD
[+] Author Affiliations

Author Affiliations:Department of Surgery, The Mount Sinai School of Medicine, New York, New York.


Section Editor: Carl E. Bredenberg, MD


Arch Surg. 2009;144(3):283-284. doi:10.1001/archsurg.2008.583-a.
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Published online

A 43-year-old man with no significant medical history had a 3-month history of right upper quadrant pain with no associated gastrointestinal or urinary symptoms. On examination, he appeared well and was in no distress. His abdomen was not tender, but had a palpable right upper quadrant fullness. A computed tomographic (CT) scan revealed a 7.9-cm, bilobed, fat-containing mass adjacent to the upper pole of the right kidney (Figure 1). A magnetic resonance image (MRI) was performed to better assess its continuity with adjacent organ structures. It showed no hepatic or renal invasion (Figure 2).

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Figure 1.

Computed tomographic scan identifying calcifications in the right adrenal gland and a 7.9-cm bilobed mass bordered by the liver (laterally), upper pole of the right kidney (inferiorly and posteriorly), vena cava (medially), and the right colon (anteriorly).

Graphic Jump Location

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Figure 2.

Magnetic resonance image showing a bilobed, smoothly marginated, fat signal intensity, right upper quadrant mass located in the Morrison pouch, likely arising from the right adrenal gland.

Graphic Jump Location

WHAT IS THE DIAGNOSIS?

A. Adrenal carcinoma

B. Teratoma

C. Adrenal myelolipoma

D. Adrenal adenoma

Figures

Place holder to copy figure label and caption
Figure 1.

Computed tomographic scan identifying calcifications in the right adrenal gland and a 7.9-cm bilobed mass bordered by the liver (laterally), upper pole of the right kidney (inferiorly and posteriorly), vena cava (medially), and the right colon (anteriorly).

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Magnetic resonance image showing a bilobed, smoothly marginated, fat signal intensity, right upper quadrant mass located in the Morrison pouch, likely arising from the right adrenal gland.

Graphic Jump Location

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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