Computed tomography and magnetic resonance imaging detected an isolated adrenal lesion in an elderly man with high-risk prostate cancer who was undergoing radiotherapy (RT) and hormonal therapy (HT). When prostate-specific antigen (PSA) was 31.66 ng/mL, the lesion was not identified as a metastasis by 18F-choline positron emission tomography/computed tomography (18F-choline-PET/CT). When PSA was over 100 ng/mL, 18F-choline-PET/CT diagnosed the malignancy. After adrenalectomy, PSA returned to normal, and stable disease remission was obtained. This case suggests that atypical metastasis may be underdiagnosed.
SubhawongA.P., SubhawongT.K., LiQ.K.Fine needle aspiration of metastatic prostate carcinoma simulating a primary adrenal cortical neoplasm: a case report and review of the literature. Diagn Cytopathol.2010; 38(2): 147–153.
2.
KawaharaT., TaguchiH., YamagishiT., UdagawaK., OuchiH., MisakiH.A case of bilateral adrenal and pleural metastases from prostate cancer. Case Rep Oncol.2009; 2(3): 217–219.
3.
SakamotoN., EtoM., AndoS.Surgical excision of a metastatic adrenal lesion in a patient with prostatic cancer. Int J Urol.1999; 6(1): 38–40.
4.
BubendorfL., SchöpferA., WagnerU.. Metastatic patterns of prostate cancer: an autopsy study of 1,589 patients. Hum Pathol.2000; 31(5): 578–583.
5.
VinjamooriA.H., JagannathanJ.P., ShinagareA.B.. Atypical metastases from prostate cancer: 10-year experience at a single institution. AJR Am J Roentgenol.2012; 199(2): 367–372.
6.
CalabriaF., ChiaravallotiA., SchillaciO.(18)F-choline PET/CT pitfalls in image interpretation: an update on 300 examined patients with prostate cancer. Clin Nucl Med.2014; 39(2): 122–130.
7.
HaraT., BansalA., DeGradoT.R.Effect of hypoxia on the uptake of [methyl-3H]choline, [1-14C] acetate and [18F]FDG in cultured prostate cancer cells. Nucl Med Biol.2006; 33(8): 977–984.
8.
FuccioC., SchiavinaR., CastellucciP.. Androgen deprivation therapy influences the uptake of 11C-choline in patients with recurrent prostate cancer: the preliminary results of a sequential PET/CT study. Eur J Nucl Med Mol Imaging.2011; 38(11): 1985–1989.
9.
DostR.J., GlaudemansA.W., BreeuwsmaA.J., de JongI.J.Influence of androgen deprivation therapy on choline PET/CT in recurrent prostate cancer. Eur J Nucl Med Mol Imaging.2013; 40(1) (Suppl 1): S41–S47.
10.
GiovacchiniG.Do we have to withdraw antiandrogenic therapy in prostate cancer patients before PET/CT with [11C] choline?Eur J Nucl Med Mol Imaging.2011; 38(11): 1964–1966.
11.
PalumboB., SivolellaS., PalumboI.. Influence of hormonal therapy in prostate cancer patients undergoing 18Fluorometh-ylcholine PET/CT: a retrospective study. Q J Nucl Med Mol Imaging.2014. Epub ahead of print.
12.
LongM.A., HusbandJ.E.Features of unusual metastases from prostate cancer. Br J Radiol.1999; 72(862): 933–941.
