Case 3

This is a CT study of the abdomen and pelvis showing high density fluid within a large left retroperitoneal, suprarenal mass which contains fat. The high density fluid, which represents haemorrhage, extends to the perinephric space on that side, as well as into the perisplenic space and collecting in the pelvis.

The haemorrhage is within a fatty mass that is clearly separate from the kidney, and is replacing the left adrenal gland. The contralateral adrenal gland also contains a well defined, small, mostly fatty mass. There is no haemorrhage into this mass.

I note that there is no active extravasation of contrast on the arterial phase, meaning that there is no ongoing bleeding.   

The findings represent acute haemorrhage from an adrenal myelolipoma in a patient with bilateral myelolipomas

I would urgently contact the referring physician in the first instance and relay the findings; urgent embolisation may be indicated in this case, vs adrenalectomy.