Source: Annual Congress 2002 - Thoracic oncology: diagnosis and prognosis
Disease area: Thoracic oncology

Abstract

Adrenal masses are found in up to 20 % of non-small cell lung cancer (NSCLC) at initial presentation. The finding of an isolated adrenal mass on CT is often a diagnostic challenge. About 2/3 of cases could be explained by an asymptomatic adrenal adenoma. An adrenal mass does not imply inoperable disease, but rather emphasizes the need for further evaluation [Vansteenkiste & Stroobants, Eur Respir J 2001, 17: 802-820]. The aim of the present investigation was to assess the usefulness of FDG-PET in differentiating benign from metastatic adrenal masses in patients with lung cancer. We analysed 850 patients undergoing PET because of suspected lung cancer. The staging procedure discovered indeterminate adrenal masses in 53 (6.2 %) patients (14x female, 39x male). Histology of the lung cancer was squamous cell carcinoma 22x, adeno carcinoma 21x, large cell carcinoma 2x, NSCLC 3x, SCLC 5x. With respect to metastatic adrenal masses, PET was true-positive in 21 cases and true-negative in 27 cases (one case unresolved). In 4 cases, unexpected adrenal metastases were detected by PET. These results confirm that FDG-PET is an accurate noninvasive way to differentiate benign from metastatic masses in lung cancer. Because we did not see any false-positive PET finding in our series, we think that a positive PET scan may obviate the need for invasive evaluation of adrenals in lung cancer.

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A. Gröschel, D. Hellwig, G. W. Sybrecht, C. M. Kirsch, D. Ukena (Homburg, Germany). Positron emission tomography with 18F-fluoro-deoxyglucose (FDG-PET) for evaluation of indeterminate adrenal mass in patients with lung cancer. Eur Respir J 2002; 20: Suppl. 38, 3724

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