18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for preoperative planning in a rare case of hyperfunctional bilateral adrenocortical carcinoma and review of literatures

Abstract

Adrenal cortical carcinoma (ACC) is a rare aggressive endocrine tumor with poor prognosis. About 60% of ACC are functional tumors. Bilateral ACC is extremely rare, roughly 2%–10% of cases. Diagnosis and staging of ACC by imaging modalities are crucial for preoperative planning and prognostication. Detection of hyperfunctional bilateral adrenocortical carcinoma by 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ( 18 F- FDG PET/CT) has never been reported. Herein, we report a male patient who presented with Cushing's syndrome, type II diabetes mellitus due to Cushing's syndrome, and hypogonadism with biopsy confirmed left ACC. He underwent 18 F-FDG PET/CT to evaluate the contralateral adrenal mass and to plan for laparoscopic adrenalectomy, which subsequently confirmed bilateral ACC. Furthermore, 18 F-FDG PET/CT was useful in staging, which revealed paraaortic lymph node and lung metastasis.

Personalized molecular visualization and radiotheranostics of adrenal tumors

“…18 F-ФДГ ПЭТ/КТ чаще всего используется в онкологии для визуализации, стадирования и мониторинга терапии. В частности, данный метод широко применяется в диагностике опухолей надпочечников для определения их функциональной активности [56]. Также проводился ряд исследований, оценивавших роль 18 F-ФДГ в оценке статуса гормональной активности инциденталом надпочечников [57][58].…”

Right Adrenocortical Carcinoma Coexisting With Left Adrenal Sarcomatoid Carcinoma on FDG PET/CT

“…3 Patients with adrenal sarcomatoid carcinomas often have atypical symptoms, whereas patients with adrenocortical carcinomas often present with hormone-related symptoms. 4 FDG PET/CT can play important roles in the evaluation of adrenal lesions. 1,2,5,6 FDG-avid bilateral adrenal masses are often indicative of the same type of diseases, including pheochromocytoma, 7 lymphoma, 8 metastases, 9 myelolipoma, 10 and infective diseases.…”

“…Bilateral adrenal glands can be involved in 15% of adrenal sarcomatoid carcinomas and 2%-10% of adrenocortical carcinomas 3. Patients with adrenal sarcomatoid carcinomas often have atypical symptoms, whereas patients with adrenocortical carcinomas often present with hormone-related symptoms 4. FDG PET/CT can play important roles in the evaluation of adrenal lesions 1,2,5,6.…”