Scintigraphic patterns of adrenocortical carcinoma: morpho-functional correlates.
OBJECTIVE
Adrenocortical scintigraphy has demonstrated clinical utility in the morpho-functional characterization of adrenal tumors. The aim of this study was to identify possible relationships between the scintigraphic pattern and endocrine and/or morphological data in a series of adrenocortical carcinomas.


METHODS
Twenty-one patients with adrenocortical carcinoma (11 nonfunctioning and 10 hormone-secreting) were investigated with 75Se-methyl-nor-cholesterol scintigraphy. Clinical, hormonal, radiological, and pathological data were analyzed.


RESULTS
The adrenal mass showed no radiocholesterol uptake in 18 cases (11 nonfunctioning and 7 functioning lesions). Contralateral normal adrenal gland was visualized in all patients with nonfunctioning tumors, whereas classic bilateral nonvisualization was observed in the 7 cases with hyperfunctioning masses. Three patients with cortisol-producing carcinomas showed radiotracer uptake by the mass, without visualization of the contralateral gland. At histology, the tumors were shown to be undifferentiated adrenocortical carcinomas; they had an aggressive clinical behavior.


CONCLUSIONS
Radiocholesterol scintigraphy has an important role in diagnosing adrenocortical carcinomas, which typically are not visualized. However, 30% of hypersecreting adrenocortical carcinomas show an atypical increased tracer uptake, not predictive of the biochemical and histological features of the tumor.
Barzon
L
L
Department of Medical and Surgical Sciences, Division of Endocrinology, University of Padova, Italy.
Zucchetta
P
P
Boscaro
M
M
Marzola
M C
MC
Bui
F
F
Fallo
F
F
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000097:blood; D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000031:analogs & derivatives*; D003480:Cushing Syndrome / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008938:Mitosis; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D016566:Organoselenium Compounds; D011877:Radionuclide Imaging; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D016566:Organoselenium Compounds; C022255:19-methyl-selenonorcholesterol; D002784:Cholesterol