Figure 4 Adrenal cortical carcinoma. Ultrasound (a) and CT image (b) of a 2.5-year-old girl with virilization show a large, well-defined, heterogeneous left suprarenal region mass (thick white arrow) with calcification. A characteristic echogenic star pattern was seen on ultrasound. The central nonenhancing hypodense area on contrast-enhanced CT is consistent with necrosis (asterisk). Thrombus within IVC is also evident (thin white arrow). CT, computed tomography; IVC, inferior vena cava.