title: Ipilimumab-Induced Adrenalitis: A Possible Pitfall in 18F-FDG-PET/CT.
abstract: Ipilimumab is a monoclonal antibody against the inhibitory CTLA-4 receptor expressed on T cells. It provokes an upregulation of the immune system. This substance was approved by the US Food and Drug Administration in 2011 and is since increasingly used as a targeted therapeutic approach for metastasized melanoma. Ipilimumab is known to cause neuroendocrine disorders, such as hypophysitis and adrenal insufficiency. Our case of a 79-year-old patient represents an important imaging pitfall. Imaging findings of newly symmetrically and smoothly enlarged, hypermetabolic adrenal glands in the setting of previous ipilimumab therapy represent drug-induced adrenalitis and not metastatic disease.
authors.affiliation: From the *Department of Medical Radiology, Division of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland; †Department of Medical Radiology, Divisions of Nuclear Medicine and Neuroradiology, University Hospital Zurich, Zurich, Switzerland; and ‡Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Sara
authors.initials: S
authors.lastname: Bacanovic
authors.forename: Irene A
authors.initials: IA
authors.lastname: Burger
authors.forename: Paul
authors.initials: P
authors.lastname: Stolzmann
authors.forename: Jürg
authors.initials: J
authors.lastname: Hafner
authors.forename: Martin W
authors.initials: MW
authors.lastname: Huellner
mesh_terms: D000308:Adrenocortical Hyperfunction / Q000139:chemically induced / Q000000981:diagnostic imaging*; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005189:False Positive Reactions; D019788:Fluorodeoxyglucose F18; D006801:Humans; D000074324:Ipilimumab; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D000074324:Ipilimumab; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18