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Rev Esp Med Nucl Imagen Mol. 2016 Mar-Apr;35(2):118-20. doi: 10.1016/j.remn.2015.08.011. Epub 2015 Oct 27.

Bilateral symmetrical adrenal hypermetabolism on FDG PET/CT due to Cushing syndrome in well differentiated neuroendocrine carcinoma.

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Trakya University Medical Faculty Hospital, Department of Nuclear Medicine, Turkey. Electronic address:
Trakya University Medical Faculty Hospital, Department of Nuclear Medicine, Turkey.


The (18)F-FDG PET/CT scan has been suggested for whole-body imaging to identify ectopic adrenocorticotrophic hormone secreting tumours, but there are some challenges involved. The case of a patient is presented, who was admitted with the pre-diagnosis of ectopic ACTH syndrome. On the CT, a nodular lesion was detected in the medial segment of the right lung. The FDG uptake of the lesion seemed to be increased visually, but was not pathological quantitatively (SUVmax: 1.8) on the PET/CT. There was also diffuse increased uptake (SUVmax: 14.2) in the enlarged adrenal glands. The lesion was reported as a possible malignant lesion with low FDG affinity, such as a low grade neuroendocrine tumour, while the diffuse enlarged adrenal glands with high uptake were interpreted as diffusely hyperplasic, due to Cushing's syndrome. The patient was treated with a surgical wedge resection. The histopathological diagnosis confirmed that the tumour was a grade 1 well-differentiated neuroendocrine carcinoma.


(18)F-FDG PET/CT; (18)F-FDG PET/TC; Adrenal metastasis; Bilateral adrenal hyperplasia; Carcinoma neuroendocrino; Cushing's syndrome; Hiperplasia adrenal bilateral; Metástasis adrenal; Neuroendocrine carcinoma; PET; Síndrome de Cushing

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