Unilateral adrenal metastasis from non–small-cell lung cancer demonstrating very high FDG uptake with a standardized uptake value in excess of sixty

Clin Nucl Med. 2012 Aug;37(8):812-4. doi: 10.1097/rlu.0b013e31824c5f6d.

Abstract

We report the case of a 52-year-old man who presented with a 2-week history of dyspnea and wheeze. CT scan of the chest showed a large soft-tissue lesion in the right main bronchus extending into the trachea. Pathologic examination of endoscopic tracheal biopsies showed features consistent with a non–small-cell lung carcinoma. 18F-FDG PET/CT showed very high uptake of FDG in the bronchial tumor (high standardized uptake values: 25.1) and unexpected very intense uptake in the left adrenal gland (high standardized uptake values: 62.5). Laparoscopic adrenalectomy was performed, and subsequent histopathological examination confirmed metastatic non–small-cell carcinoma in the adrenal gland. Although adrenal malignancies are generally metabolically active, such high uptake of FDG within a metastatic lesion has not been reported previously.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Gland Neoplasms / diagnostic imaging*
  • Adrenal Gland Neoplasms / pathology
  • Adrenal Gland Neoplasms / secondary*
  • Adrenal Gland Neoplasms / surgery
  • Adrenal Glands / diagnostic imaging
  • Adrenal Glands / pathology
  • Adrenal Glands / surgery
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Humans
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Positron-Emission Tomography
  • Tomography, X-Ray Computed

Substances

  • Fluorodeoxyglucose F18