Figure 1

Pretreatment imaging of an adrenal collision tumor. (A) Non-contrast axial computed tomography scan (CT) demonstrating two distinct lesions in the left adrenal gland: a low attenuation 2.9 × 3.1-cm lesion as well as a higher attenuation 1.2 × 1.4-cm nodule, suspicious for metastatic disease. (B) Fused CT/fluorodeoxyglucose (FDG) positron emission tomography scan demonstrates an FDG avid lesion in the high attenuation component (standardized uptake value (SUVmax) 7) and no significant uptake in the low attenuation component. (C) Opposed-phase axial magnetic resonance imaging shows loss of signal intensity in the majority of the left adrenal mass, consistent with a lipid-rich adrenal adenoma, largely surrounding a 1.2-cm mass within the lateral portion of the adrenal gland that did not lose signal intensity, suggestive of metastatic disease.