title: Utility of F-18 FDG-PET in detecting primary aldosteronism in patients with bilateral adrenal incidentalomas.
abstract: In patients with primary aldosteronism who have bilateral adrenal incidentalomas, it is important to identify which adrenal gland is secreting excess aldosterone. Traditionally, adrenal vein sampling (AVS) has been performed for lateralization despite its invasiveness. Here we report a case of bilateral adrenal incidentaloma in which 18-Fluorodeoxyglucose (FDG)-positron emission tomography (PET) was used to identify the functional adrenal mass. A 53-yr-old man was referred to our clinic due to bilateral adrenal incidentalomas (right: 1 cm, left: 2.5 cm) on computed tomography (CT). Given his history of colon cancer, FDG-PET/CT scanning was used to rule out metastasis. Although there was focal hot uptake lesion in the right adrenal gland, the patient was suspected primary aldosteronism clinically more than metastasis because of the patient's underlying hypertension with hypokalemia. It was consistent with the results of AVS. Based on these findings, we propose that FDG-PET/CT can be used instead of AVS to identify the source of primary aldosteronism between two bilateral adrenal incidentalomas.
authors.affiliation: Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Myung Kwan
authors.initials: MK
authors.lastname: Ko
authors.forename: Chan Sung
authors.initials: CS
authors.lastname: Park
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Byun
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Hong
authors.forename: Mu Yeol
authors.initials: MY
authors.lastname: Lee
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Kim
authors.forename: Yang Won
authors.initials: YW
authors.lastname: Na
authors.forename: Hye Jeong
authors.initials: HJ
authors.lastname: Choi
authors.forename: Il Sung
authors.initials: IS
authors.lastname: Nam-Goong
authors.forename: Young Il
authors.initials: YI
authors.lastname: Kim
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Kim
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000311:Adrenal Glands / Q000473:pathology / Q000601:surgery; D019788:Fluorodeoxyglucose F18; D006801:Humans; D006929:Hyperaldosteronism / Q000175:diagnosis* / Q000473:pathology; D006973:Hypertension / Q000175:diagnosis; D007008:Hypokalemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Bilateral Adrenal Incidentaloma; FDG-PET/CT; Primary Aldosteronism