title: Imaging and management of a small cell lung cancer metastasis/adrenal adenoma collision tumor: a case report and review of the literature.
abstract: OBJECTIVE
  We report a case of an adrenal collision tumor composed of a small cell lung carcinoma metastasis and a benign adrenal adenoma identified preoperatively on FDG-PET, CT and MRI and confirmed pathologically.
  
  
  METHODS
  The patient's history, preoperative imaging characteristics, postoperative course, and histopathology are described. A review of the literature addressing adrenal collision tumors is provided.
  
  
  RESULTS
  A 47-year-old female was found to have a left upper lobe lung mass and an adrenal lesion on imaging. FDG-PET, CT and MRI of the adrenal suggested a metastatic lesion adjacent to an adrenal adenoma. CT-guided biopsy of the adrenal gland was consistent with a small cell lung cancer metastasis. The patient underwent systemic chemotherapy and had complete resolution of the left upper lobe mass. Post-treatment FDG-PET demonstrated a persistently enlarged adrenal gland with decreased but persistent FDG uptake. The patient underwent adrenalectomy and pathologic examination demonstrated a small cell lung cancer/adenoma collision tumor.
  
  
  CONCLUSIONS
  This case and a review of the literature demonstrate that FDG, CT and MR imaging can all characterize the separate components of collision tumors within the adrenal gland.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA. untchb@mskcc.org.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Untch
authors.forename: Jinru
authors.initials: J
authors.lastname: Shia
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Downey
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Carrasquillo
authors.forename: David M
authors.initials: DM
authors.lastname: Panicek
authors.forename: Vivian E
authors.initials: VE
authors.lastname: Strong
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D000315:Adrenalectomy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D055752:Small Cell Lung Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18