Figure 6c. Adrenal carcinoma in a 32-year-old woman with Cushing syndrome. (a) Unenhanced CT scan demonstrates a large, low-attenuation suprarenal mass (short arrows) containing areas of high attenuation (long arrows) that are consistent with hemorrhage. (b) Contrast-enhanced CT scan demonstrates the mass with heterogeneous enhancement. Large areas of necrosis are also seen (*). Note the anterior displacement and compression of the inferior vena cava (IVC) (arrow). (c) Axial T1-weighted MR image (500/14) demonstrates high-signal-intensity areas within the mass (arrow), a finding that is consistent with hemorrhage. (d) Axial fast spin-echo T2-weighted MR image (7,500/100) also demonstrates extensive high-signal-intensity areas within the mass (arrow), a finding that is consistent with necrosis. (e) Photomicrograph (original magnification, x100; H-E stain) demonstrates amorphous necrosis (arrows), a finding that is seen in the majority of adrenal carcinomas.