Background

Up to 70% of adrenal masses detected in patients affected by extra-adrenal malignancy are metastatic lesions. Therefore, detection of an adrenal mass in patients with active or previous malignancy requires a careful differential diagnostic workup. ¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG-PET/CT) is increasingly being used to determine the malignant potential of adrenal lesions.

Clinical case

We report the case of a 64-year-old man who had a single adrenal metastasis due to non-small-cell lung carcinoma developing on a pre-existing benign adrenal lesion. This metastasis occurred in a phase of perceived oncological remission and was detected thanks to ¹⁸F-FDG-PET/CT showing a focal adrenal uptake. Contrast-enhanced computed tomography (CT), performed as part of oncological follow-up, and MRI with chemical shift sequences did not lead to the correct diagnosis. The patient underwent laparoscopic adrenalectomy and the pathological evaluation confirmed a lung carcinoma metastasis.

Conclusion

The present case highlights the peculiarity of the follow-up of adrenal masses in cancer patients and the primary role of ¹⁸F-FDG-PET/CT in the management of such patients.

中文翻译：

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肾上腺偶发瘤会改变其性质吗？

背景

在受肾上腺恶性肿瘤影响的患者中，检测到的肾上腺肿块中多达70％是转移性病变。因此，对活动性或先前恶性肿瘤患者的肾上腺肿块的检测需要仔细的鉴别诊断检查。¹⁸ F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（¹⁸ F-FDG-PET / CT）正越来越多地用于确定肾上腺病变的恶性潜能。

临床案例

我们报告了一个病例，该病例是由于非小细胞肺癌在既存的良性肾上腺病变上发展而导致的单个肾上腺转移。这种转移发生在可感觉到的肿瘤缓解期，由于¹⁸ F-FDG-PET / CT显示出局灶性肾上腺摄取而被检测到。作为肿瘤学随访的一部分，对比增强计算机断层扫描（CT）和具有化学位移序列的MRI不能正确诊断。该患者接受了腹腔镜肾上腺切除术，病理评估证实了肺癌的转移。

结论

本案强调了癌症患者肾上腺肿块的随访的特殊性，以及¹⁸ F-FDG-PET / CT在此类患者管理中的主要作用。