Figure 6.

A 51-year-old man with a right adrenal nodule discovered during the initial staging of skin melanoma. Unenhanced (A) and contrast-enhanced CT images obtained at 60 s (B) and 10 min (C) after intravenous administration of iodinated contrast material in the axial plane show a nodule (arrows) in the right adrenal body. The nodule has attenuation values of 30 HU in the unenhanced image, 55 HU at 60 s and 40 HU at 10 min; the absolute washout is 0.60 and the relative washout is 0.27, which are not associated with a typical benign adrenal lesion. The unenhanced T1-weighted in phase (D) and out-of-phase (E) MR images in the axial plane show no signal drop of the nodule (arrows) in the out-of-phase image. (F) The ¹⁸F-FDG PET/CT image in the axial plane shows marked uptake of ¹⁸F-FDG by the right adrenal nodule. The nodule has a maximal standardized uptake value (SUVmax) of 8.4 and a liver-to-adrenal ratio of 3.8. Histopathologic analysis of a biopsy specimen obtained from percutaneous biopsy confirmed melanoma metastasis to the right adrenal gland.