Signalment: 13 year old MN DSH

Radiologist's Description: This is a 7-month recheck of the left adrenal mass noted in the prior two images. This is a right lateral approach to the left adrenal mass located in the far field surrounded by echogenic fat (larger arrow). Significant progression of the tumor's luminal invasion and/or thrombus has occurred within the caudal vena cava (small arrows) to the level of the diaphragm. Conclusions: Progressively invasive left adrenal mass with marked adjacent caudal vena caval luminal involvement (CVC).

Definitive Diagnosis: US Dx: Invasive left adrenal tumor. ACTH stimulation and clinical diagnosis were consistent with a functional left adrenal adenocarcinoma. There was full invasion of the vena cava.