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Markedly increased 18F-FDG uptake in a nonfunctioning adrenal adenoma mimicking malignancy
Giorgio Treglia1, Luigi Oragano, Guido Fadda
1Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Rome, Italy. giorgiomednuc@libero.it
Clinical Nuclear Medicine
|March 15, 2013
Summary
Nonfunctioning adrenal adenomas can mimic malignancy on PET/CT scans. This case highlights the potential for false-positive findings, even with high radiopharmaceutical uptake, in evaluating adrenal incidentalomas.
Area of Science:
- Nuclear Medicine
- Radiology
- Endocrinology
Background:
- Adrenal incidentalomas are common findings during imaging for other conditions.
- Positron Emission Tomography/Computed Tomography (PET/CT) with fluorodeoxyglucose (FDG) is frequently used to evaluate adrenal lesions.
- Distinguishing benign from malignant adrenal masses is crucial for patient management.
Observation:
- A 63-year-old woman presented with fever of unknown origin, undergoing FDG PET/CT.
- The scan incidentally revealed a focal area of markedly increased FDG uptake in the right adrenal gland.
- This finding raised suspicion for adrenal malignancy or a functioning adenoma.
Findings:
- Histopathology and laboratory tests confirmed the adrenal lesion was a nonfunctioning adenoma.
- Despite significant FDG uptake, the adenoma was benign and hormonally inactive.
- This demonstrates a false-positive PET/CT finding for malignancy.
Implications:
- Nonfunctioning adrenal adenomas can exhibit high FDG uptake, mimicking malignancy on PET/CT.
- Adrenal incidentalomas with marked FDG uptake require careful interpretation to avoid misdiagnosis.
- Consideration of benign etiologies is essential in the PET/CT evaluation of adrenal lesions.
