title: Unilateral adrenal metastasis from non–small-cell lung cancer demonstrating very high FDG uptake with a standardized uptake value in excess of sixty.
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.
authors.affiliation: Nuclear Medicine Centre, Central Manchester University Hospitals, Manchester, United Kingdom. mohamed.shawgi@cmft.nhs.uk
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shawgi
authors.forename: Jackie
authors.initials: J
authors.lastname: James
authors.forename: Mary
authors.initials: M
authors.lastname: Prescott
authors.forename: Lorna
authors.initials: L
authors.lastname: McWilliam
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18