Metastatic bilateral adrenal sarcomatoid carcinoma: Evaluation by 18F-FDG PET/CT

Document Type : Case report

Authors

Department of Nuclear medicine, The Gujarat Cancer & Research Institute, New Civil Hospital Campus, Ahemdabad, India

Abstract

Sarcomatoid carcinoma of  the adrenal gland is an uncommon presentation of malignant adrenal tumors and bilateral presentation is extremely rare. It is an extremely rare occurrence, unusual symptoms, and both epithelioid and sarcomatoid components in histology are a challenge to diagnose sarcomatoid carcinoma of adrenal origin. The majority of patients are diagnosed at a later stage while having metastatic disease and succumb due to disease within a few months of diagnosis due to the aggressive nature of the disease. Probably due to the advanced disease at the time of diagnosis; patients diagnosed having adrenal sarcomatoid tumor have a very poor prognosis. In nonmetastatic disease, adjuvant chemotherapy is suggested after the removal of the tumor. It is essential to diagnose these tumors earliest to treat with effective treatment modalities. The present study describes the rare case of sarcomatoid carcinoma involving the bilateral adrenal gland with metastasis to bones, lymph nodes, and pleura evaluated by 18F-FDG PET/CT.

Keywords

References

  1. Sasaki K, Desimone M, Rao HR, Huang GJ, Seethala RR. Adrenocortical carcino-sarcoma: a case report and review of the literature. Diagnostic pathology. 2010; 5(1):1-7.
  2. Sabrine D, Zakia B, Kaoutar Z. Adrenocortical sarcomatoid carcinoma: A case report and review of the literature. Journal of Surgical Case Reports. 2020; 2020(7):rjaa211.
  3. Turhan Iyidir O, Cerit ET, Özkan Ç, Altınova E, Çimen AR, Sözen S, et al. A case report of bilateral adrenal sarcomatoid carcinoma. Case reports in surgery. 2016.
  4. Ishikawa N, Nagase M, Takamietal S. A case report of bilateral sarcomatoid carcinoma of adrenal glands with adrenal insufficiency.Int J Surg Pathol. 2016; 24(8):743-748.
  5. Dong A, Cui Y, Wang Y, Zuo C, Bai Y. 18F-FDG PET/CT of Adrenal Lesions. AJR Am J Roentgenol. 2014; 203(2):245-52.
  6. Castinetti F, Verschueren A, Cassagneau P, Brue T, Sebag F, Daniel L, et al. Adrenal Myelolipoma: An Unusual Cause of Bilateral Highly 18F-FDG-Avid Adrenal Masses. J Clin Endocrinol Metab. 2012; 97(8):2577–2578.
  7. Joseph UA, Barron BJ, Wan DQ. (18)F-Fluorodeoxy glucose (FDG) uptake in nontraumatic bilateral adrenal hemorrhage secondary to heparin-associated thrombo-cytepenia syndrome (HATS) - a case report. Clin Imaging. 2007; 31(2):137-40.
  8. Jinguji M, N Masatoyo, Nakajo Masayuki Nakabepu Y, Yoshiura T. Vasovagal-related stress immediately before FDG injection may increase bilateral adrenal FDG uptake. Br J Radiol; 89:20150950.
  9. Lam KY, Lo CY. Metastatic tumours of the adrenal glands: a 30‐year experience in a teaching hospital. Clinical endocrino-logy.2002; 56(1):95-101.
  10. Fassnacht M, Arlt W, Bancos I, Dralle H, Newell-Price J, Sahdev A, et al. Management of adrenal incidentalomas: European society of endocrinology clinical practice guideline in collabo-ration with the European network for the study of adrenal tumors. European journal of endocrinology. 2016; 175(2): G1-G34.
  11. Collina G, Maldarizzi F, Betts C, Eusebi V. Primary sarcomatoid carcinoma of the adrenal gland. Virchows Archiv A. 1989; 415(2):161-7.
  12. Zhu C, Zheng A, Mao X, Primary adrenal sarcomatoid carcinoma metastatic to the lung: Case report and review of the Oncol Lett. 2016; 11(5):3117-3122.
  13. Gupta P, Bhalla A, Sharma R. Bilateral adrenal lesions. Journal of Medical Imaging and Radiation Oncology. 2012; 56(6):636-45.
  14. Mark D, Boyd C, Eatock F. Adrenal Sarcomatoid Carcinoma: A case report and review of the literature. Ulster Med J 2014; 83(2):89-9.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 10, Issue 2
July 2022
Pages 151-154

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