1.Adrenal Metastasis from Hepatocellular Carcinoma without Intrahepatic Recurrence after Hepatic Resection.
Sung Min AHN ; Min Young JUNG ; Hyeok Soo CHOI ; Bo Youn CHOI ; Seung In SEO ; Du Jin KIM ; Seung Jin CHO ; Hyoung Su KIM
The Korean Journal of Gastroenterology 2012;59(4):308-312
Although the adrenal gland is a common site of metastasis from hepatocellular carcinoma (HCC), adrenal metastases are rarely seen in clinical practice because of its lower metastatic potential compared to the other malignancies. Adrenal metastases usually were detected at the time of diagnosis of primary HCC or simultaneously with intrahepatic recurrence after curative management of HCC. It is very rare that only metastatic HCC is detected without evidence of intrahepatic recurrence. Hereby, we report two cases of adrenal metastasis from HCC without intrahepatic recurrence after hepatic resection.
Adrenal Gland Neoplasms/*diagnosis/radionuclide imaging/secondary
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Aged, 80 and over
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Carcinoma, Hepatocellular/*pathology/surgery
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Humans
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Liver Neoplasms/*pathology/surgery
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Male
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Positron-Emission Tomography
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Tomography, X-Ray Computed
2.Utility of F-18 FDG-PET in Detecting Primary Aldosteronism in Patients with Bilateral Adrenal Incidentalomas.
Myung Kwan KO ; Chan Sung PARK ; Sung Soo BYUN ; Jung Min HONG ; Mu Yeol LEE ; Kyung Hoon KIM ; Yang Won NA ; Hye Jeong CHOI ; Il Sung NAM-GOONG ; Young Il KIM ; Eun Sook KIM
Journal of Korean Medical Science 2013;28(3):489-492
In patients with primary aldosteronism who have bilateral adrenal incidentalomas, it is important to identify which adrenal gland is secreting excess aldosterone. Traditionally, adrenal vein sampling (AVS) has been performed for lateralization despite its invasiveness. Here we report a case of bilateral adrenal incidentaloma in which 18-Fluorodeoxyglucose (FDG)-positron emission tomography (PET) was used to identify the functional adrenal mass. A 53-yr-old man was referred to our clinic due to bilateral adrenal incidentalomas (right: 1 cm, left: 2.5 cm) on computed tomography (CT). Given his history of colon cancer, FDG-PET/CT scanning was used to rule out metastasis. Although there was focal hot uptake lesion in the right adrenal gland, the patient was suspected primary aldosteronism clinically more than metastasis because of the patient's underlying hypertension with hypokalemia. It was consistent with the results of AVS. Based on these findings, we propose that FDG-PET/CT can be used instead of AVS to identify the source of primary aldosteronism between two bilateral adrenal incidentalomas.
Adrenal Gland Neoplasms/*diagnosis/pathology/radionuclide imaging
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Adrenal Glands/pathology/surgery
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Fluorodeoxyglucose F18/diagnostic use
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Humans
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Hyperaldosteronism/*diagnosis/pathology
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Hypertension/diagnosis
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Hypokalemia/diagnosis
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Male
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Middle Aged
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Positron-Emission Tomography and Computed Tomography
3.(18)F-FDG PET versus (18)F-FDG PET/CT for Adrenal Gland Lesion Characterization: a Comparison of Diagnostic Efficacy in Lung Cancer Patients.
Yon Mi SUNG ; Kyung Soo LEE ; Byung Tae KIM ; Joon Young CHOI ; Myung Jin CHUNG ; Young Mog SHIM ; Chin A YI ; Tae Sung KIM
Korean Journal of Radiology 2008;9(1):19-28
OBJECTIVE: The aim of this study was to assess the diagnostic efficacy of integrated PET/CT using fluorodeoxyglucose (FDG) for the differentiation of benign and metastatic adrenal gland lesions in patients with lung cancer and to compare the diagnostic efficacy with the use of PET alone. MATERIALS AND METHODS: Sixty-one adrenal lesions (size range, 5-104 mm; mean size, 16 mm) were evaluated retrospectively in 42 lung cancer patients. Both PET images alone and integrated PET/CT images were assessed, respectively, at two-month intervals. PET findings were interpreted as positive if the FDG uptake of adrenal lesions was greater than or equal to that of the liver, and the PET/CT findings were interpreted as positive if an adrenal lesion show attenuation > 10 HU and showed increased FDG uptake. Final diagnoses of adrenal gland lesions were made at clinical follow-up (n = 52) or by a biopsy (n = 9) when available. The diagnostic accuracies of PET and PET/CT for the characterization of adrenal lesions were compared using the McNemar test. RESULTS: Thirty-five (57%) of the 61 adrenal lesions were metastatic and the remaining 26 lesions were benign. For the depiction of adrenal gland metastasis, the sensitivity, specificity, and accuracy of PET were 74%, 73%, and 74%, respectively, whereas those of integrated PET/CT were 80%, 89%, and 84%, respectively (p values; 0.5, 0.125, and 0.031, respectively). CONCLUSION: The use of integrated PET/CT is more accurate than the use of PET alone for differentiating benign and metastatic adrenal gland lesions in lung cancer patients.
Adrenal Gland Neoplasms/pathology/*radiography/*radionuclide imaging/secondary
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Adult
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Aged
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Biopsy
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Diagnosis, Differential
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Female
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Fluorodeoxyglucose F18/*diagnostic use
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Humans
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Lung Neoplasms/pathology/*radiography/*radionuclide imaging
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Male
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Middle Aged
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Positron-Emission Tomography/*methods
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Radiopharmaceuticals/*diagnostic use
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Retrospective Studies
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Sensitivity and Specificity
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Tomography, X-Ray Computed/*methods