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+A 41-year-old man with weight loss, nausea, vomiting, and abdominal pain was referred for an abdominal CT scan to rule out intraabdominal pathology.
+A dedicated CT of the abdomen was performed at our institution according to our standard venous phase protocol.
+Following ingestion of positive oral contrast material (barium sulfate suspension 2.1% w/v, Mallinckrodt) and injection of 125 ml of iopromide, 300 mg I/mL (Ultravist, Bayer HealthCare), helical CT was obtained with a 65-s delays using a 64-slice GE Lightspeed VCT scanner (GE Medical Systems; Milwaukee, WI).
+Axial sections of the abdomen showed a large (18×22×22 cm) heterogeneous retroperitoneal mass probably arising from the left adrenal gland containing multiple areas of macroscopic fat (Fig.1).
+The patient had no documented clinical or laboratory evidence of adrenal hormonal excess.
+On the basis of the clinical history and CT findings, the patient underwent surgical resection of the left adrenal mass, which was found on pathologic examination to represent a low-grade adrenocortical carcinoma.