title: Preoperative FDG PET/CT in adrenocortical cancer depicts massive venous tumor invasion.
abstract: A 79-year-old woman presented with abdominal pain. Ultrasound revealed an intra-abdominal mass in the left renal region. Comprehensive endocrine workup was unremarkable. The patient was referred for further diagnostic workup. FDG PET/CT revealed a hypermetabolic mass in the left adrenal region. In addition, pathologically increased tracer uptake of 2 renal veins (the upper vein crossing in front of the aorta the lower one crossing behind the aorta) and the inferior vena cava raised the concern for malignant venous infiltration. Adrenalectomy, nephrectomy, and thrombectomy were carefully planned and performed. Adrenocortical carcinoma with tumor thrombus and caval extension was proven by histopathology.
authors.affiliation: From the *Department of Nuclear Medicine, and †Comprehensive Heart Failure Center, Universitätsklinikum Würzburg, Würzburg, Germany.
authors.forename: Constantin
authors.initials: C
authors.lastname: Lapa
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: Werner
authors.forename: Joachim
authors.initials: J
authors.lastname: Brumberg
authors.forename: Takahiro
authors.initials: T
authors.lastname: Higuchi
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D019788:Fluorodeoxyglucose F18