prominent 18f-fdg uptake in the adrenal gland after contralateral adrenalectomy in a known case of adrenocortical oncocytic carcinoma

Adrenocortical carcinoma (acc) is a rare type of cancer that is associated with a high rate of recurrence and poor prognosis. the main diagnostic approaches to adrenocortical cancer include ct scan, mri and the promising role of 18f-fdg pet/ct. the main therapeutic approaches include radical surgery of local disease and recurrences, as well as adjuvant mitotane therapy.the evaluation of adrenocortical carcinoma (acc) could be difficult by using 18f-fdg pet/ct in view of the significant association between the 18f-fdg uptake and acc. at the same time, not all adrenal glands with 18f-fdg uptake are considered to be malignant, so awareness of these various findings is substantial for acc management, especially with limited data regarding the role of 18f-fdg pet/ct in acc post-operative settings.this report discusses the case of a 47-year-old man with a history of left adrenocortical carcinoma who underwent adrenalectomy and received adjuvant mitotane therapy. 9 months after the surgery, a follow-up 18f-fdg pet/ct scan showed that the 18f-fdg uptake was prominent in the right adrenal gland without corresponding abnormal ct scan findings.