FORTUITOUS IMAGING OF A PRIMARY ADRENOCORTICAL CARCINOMA WITH TC-99M HDP

The importance of evaluating nonfunctional adrenal masses in the right clinical setting is discussed. A 60-year-old man was initially diagno sed of having a localized lung carcinoma. Metastatic work-up showed an adrenal mass that was not deemed to be related to the lung primary. A lthough biochemical testing revealed that the adrenal mass was nonfunc tional, adrenal scintigraphy was not performed. On resection, the lung neoplasm was shown to be a poorly differentiated adenocarcinoma. Radi ologic follow-up of the adrenal finding was recommended. A year later, the patient presented with an abdominal mass that was visualized by b one scintigraphy and, on resection, proved to be an adrenocortical car cinoma. In retrospect, the lung mass was a metastasis of an adrenocort ical carcinoma.