Figure 4.
A 67-year-old woman with left ACC. (a–c) CT images show a well-defined mass with heterogeneous contrast enhancement and a central area of hypodensity arising from the left adrenal gland. Thin enhancing rim (black arrows), tumoural extension into the left renal vein and IVC (thick white arrows). Several enlarged retroperitoneal lymph nodes (thin white arrows) were detected and histopathologically confirmed to be metastases. (d) The image shows the thrombus in the left renal vein extending inferiorly into the left gonadal vein. The IVC thrombus is still visible in this image (thick white arrows).