PMC9300412_01
(a and b) Coronal sections on computed tomography (CT) scans showing bilateral adrenal masses (right of 66 mm and left of 106 mm).
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A 62-year-old woman with a previous history of colorectal cancer was referred to our surgical department for presenting bilateral adrenal masses found on an abdominal CT scan at month 9 follow-up (Figure 1), associated with increasing levels of adrenocorticotropic hormone (ACTH) (last value: 320 pg/ml; normal value: <54 pg/ml) and low levels of dehydroepiandrosterone (86 ng/ml; normal value: 336-2,490 ng/ml).
(a) Coronal section on MRI in T2-weighted sequence showing bilateral adrenal masses (right of 75 x 52 mm and left of 98 x 49 mm). (b) Similar section in T1-weighted with fat suppression and Gadolinium sequence. (c and d) PET-CT showing peripheral metabolic increase in nodular formations in right and left adrenal glands, with 8.8 and 6.1 SUV, respectively.
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Abdominal MRI is shown in Figure 2a and b. PET-CT was also performed showing hypermetabolic bilateral adrenal masses with no systemic disease (Figure 2c and d).
(a) Left surgical site post-adrenalectomy. Arrow: left renal vein; LK: left kidney; LD: left diaphragm. (b) Right (R) and left (L) adrenal glands sectioned.
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The patient underwent open bilateral adrenalectomy with two subcostal incisions (Figure 3).