PMC3748408_01
Bilateral adrenal gland metastases from an endometrial cancer primary. (a) Imaging of the adrenal metastases. FDG-PET CT scan images revealed enlarged adrenal glands with increased FDG uptake in both adrenal glands. The upper panels show transaxial CT (left) and FDG-PET (right) images of the adrenals. The lower panel on the left shows a fused CT/ FDG-PET transaxial image, and the lower panel on the right shows a coronal image of the FDG-PET scan. (b) Histological confirmation of the adrenal metastases. The top panel shows a hematoxylin and eosin (H&E) stained image of the primary endometrial tumor (original magnification x200), with predominantly solid proliferation and scattered endometrial glands. The middle panel is an H&E stain of a core biopsy from the right adrenal gland mass (original magnification x100) showing viable discohesive tumor cells (lower field) and a large area of confluent tumor necrosis (upper field). The lower panel is an H&E touch cytologic preparation of the right adrenal biopsy (original magnification x400), showing a cluster of round tumor cells.
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Fluorodeoxyglucose positron emission tomography (FDG-PET) one month later revealed bilateral adrenal gland masses with intense FDG uptake (Figure 1(a)). Biopsy of the right side revealed a predominantly necrotic carcinoma consistent with the patient's primary endometrial tumor (Figure 1(b)).