Abstract:
Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis. Its diagnosis requires clinical suspicion and confirmation through laboratory and imaging studies, including computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasound, as well as histological confirmation. Positron emission tomography (PET) is useful for distinguishing between benign and malignant lesions and for evaluating tumor recurrences or metastases. A case is described in which the uptake of fluorodeoxyglucose (18F-FDG) in a remnant adrenal gland could be misinterpreted as tumoral pathology. The article presents the case of a patient with ACC who, after treatment, showed increased FDG uptake in the remnant adrenal gland, which disappeared after discontinuation of treatment with mitotane. Possible explanations for this increase in FDG uptake are discussed, including the action of mitotane. In summary, it is highlighted that FDG uptake in remnant adrenal glands in patients treated with mitotane does not always indicate tumor recurrence or adrenal hypertrophy.
摘要:
肾上腺皮质癌(ACC)是一种罕见的恶性肿瘤,预后不良。它的诊断需要临床怀疑和通过实验室和影像学检查确认,包括计算机断层扫描(CT),磁共振成像(MRI),还有腹部超声,以及组织学确认。正电子发射断层扫描(PET)可用于区分良性和恶性病变以及评估肿瘤复发或转移。描述了一个案例,其中残余肾上腺中氟脱氧葡萄糖(18F-FDG)的摄取可能被误解为肿瘤病理学。这篇文章介绍了一名ACC患者的情况,治疗后,显示残余肾上腺的FDG摄取增加,停止米托坦治疗后消失。讨论了FDG摄取增加的可能解释,包括米托坦的作用。总之,需要强调的是,在接受米托坦治疗的患者中,残余肾上腺的FDG摄取并不总是提示肿瘤复发或肾上腺肥大.