子宮頸癌副腎転移との鑑別が困難であった18F-FDG PET/CT陽性副腎皮質腺腫の1例

Abstract

A 61-year-old woman was referred to our department with a diagnosis of left solitary adrenal metastasis from cervical cancer in September 2011. She presented with postmenopausal bleeding in September 2010. The patient received seven courses of paclitaxel (175 mg/m2) and carboplatin (6 mg/GFR＋25) for stage IV cervical cancer with paraaortic, bilateral common iliac, mediastinal lymph node metastases and left adrenal metastasis from October 2010 to April 2011. Paraaortic radiation (50.4 Gy) was subsequently administered from May 2011 to July 2011. Abdominal nonenhanced computed tomography (CT) revealed a left 26×21 mm adrenal mass with regular margins (attenuation values 53 HU). On enhanced CT, the mass showed heterogeneous enhancement. F fluoro-2-deoxy D-glucose (FDG) positron emission tomography/CT images showed moderately increased FDG-avid uptake in the left adrenal tumor which was high enough to be suspicious of malignant tumor (standardized uptake value max : SUVmax 6.8). There were no other foci of pathologic uptake of FDG in the whole body. The plasma endocrinological examinations was all normal. Left laparoscopic adrenalectomy was performed. The final pathologic evaluation revealed adrenal cortical adenoma.