Colon Cancer Metastasis to the Adrenal Gland Demonstrated with FDG PET/CT

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A patient with synchronous hepatic metastases from colon cancer, treated with IV irinotecan and hepatic artery infusion of floxuridine for 17 cycles was followed with CEA monthly that showed an initial decrease but later increased from 5 to 24. Three monthly CT scans had shown only regressing liver lesions. An FDG PET/CT study showed no abnormality in the liver, but an abnormal focus of increased FDG uptake was noted in the right adrenal gland (SUV maximum, 6.1). Right adrenalectomy revealed a 1.5-cm metastatic adenocarcinoma and led to a fall in CEA.

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