title: Abrupt enlargement of adrenal incidentaloma: a case of isolated adrenal metastasis.
abstract: A 56-year-old Japanese man was referred for examination of right adrenal tumor (3 cm). He had no apparent preexisting cancer by radiological workup and accordingly, the patient was considered as a nonfunctioning adrenocortical adenoma and scheduled for periodic CT scans every 6 months. However, five months after the initial diagnosis the patient complained of severe right back pain with remarkable enlargement of both adrenals (~20-fold volume). Although the origin of adrenal tumor was uncertain by pathological workup, positron emission tomography (PET) scan with (18)F-2-fluoro-D-deoxyglucose (FDG) eventually revealed a hot spot on left upper lung, which was consistent with a lesion of thickened bulla wall observed by chest CT. The present case is a very rare example of abrupt enlargement of bilateral adrenals due to clinically isolated adrenal metastasis, suggesting the requirement of frequent observation with greatest care regarding morphologic changes of adrenal incidentalomas.
authors.affiliation: Department of Medicine and Clinical Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Miyoshi
authors.forename: Fumio
authors.initials: F
authors.lastname: Otsuka
authors.forename: Jiro
authors.initials: J
authors.lastname: Suzuki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Inagaki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kano
authors.forename: Toshio
authors.initials: T
authors.lastname: Ogura
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kiura
authors.forename: Takashi
authors.initials: T
authors.lastname: Saika
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Makino
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D000306:Adrenal Cortex Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000473:pathology; D018246:Adrenocortical Adenoma / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011859:Radiography; D014463:Ultrasonography
chemical_list: D006854:Hydrocortisone