Hemorrhagic adrenal adenoma simulating myelolipoma: CT evaluation.

We present a hemorrhagic adrenal adenoma surrounding and encompassing adjacent retroperitoneal fat to simulate the appearance of a myelolipoma by CT. A well-defined fibrous capsule, punctate calcification, and several macroscopic foci of fat within the mass led to an erroneous preoperative diagnosis. Lesions displaying large amounts of soft tissue attenuation material in addition to fat preclude a confident diagnosis of myelolipoma and should undergo directed percutaneous needle biopsy or surgery.