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Abstract

Purpose: Presence of distant metastasis is a strong independent predictor of poor survival in patients with renal cell carcinoma (RCC). Positron emission tomography using F-18 fluorodeoxyglucose (FDG) has been reported to be superior to conventional anatomic imaging modalities for detecting distant metastases from RCC. Methods: The authors report the findings of four patients who underwent FDG positron emission tomography / computed tomography (PET/CT) at varying periods after radical nephrectomy for RCC.Results: FDG PET/CT detected increased tracer concentration in the adrenal glands in all four patients and subsequent fine needle aspiration confirmed metastatic RCC. While the adrenal was the only site of metastasis in one patient, additional metastases were detected in lymph nodes and lungs in the others. Conclusions: RCC metastatic to the adrenal gland is usually a vascular tumour and there is an intrinsic risk of haemorrhage during CT-guided needle biopsy. This small series of cases suggests that FDG PET/CT is a useful non-invasive investigation in identifying malignant adrenal lesions in patients with RCC presenting after nephrectomy.