Renal Cell Carcinoma and an Incidental Adrenal Lesion: Adrenal Collision Tumors

Incidental adrenal lesions are common in patients with primary renal cell carcinoma (RCC). Modern cross-sectional imaging, especially phase-shift, magnetic resonance imaging, is an important adjunct in evaluating adrenal lesions. We present the case of an incidental left adrenal nodule consistent with an adenoma in a patient with a history of pT2 RCC status post right nephrectomy. He subsequently developed multiple renal lesions in the contralateral solitary kidney. Despite meeting radiographic criteria for an adenoma, surgical resection of the adrenal at the time of partial nephrectomy demonstrated RCC metastatic to the adrenal.