Imaging and management of a small cell lung cancer metastasis/adrenal adenoma collision tumor: a case report and review of the literature.

World journal of surgical oncology

PubMedID: 24571800

Untch BR, Shia J, Downey RJ, Carrasquillo JA, Panicek DM, Strong VE. Imaging and management of a small cell lung cancer metastasis/adrenal adenoma collision tumor: a case report and review of the literature. World J Surg Oncol. 2014;12(1):45.
OBJECTIVE
We report a case of an adrenal collision tumor composed of a small cell lung carcinoma and a benign adrenal adenoma identified preoperatively on FDG-PET, CT and MRI and confirmed pathologically.

METHODS
The patient's history, preoperative imaging characteristics, postoperative course, and histopathology are described. A review of the literature addressing adrenal collision tumors is provided.

RESULTS
A 47-year-old female was found to have a left upper lobe lung mass and an adrenal lesion on imaging. FDG-PET, CT and MRI of the adrenal suggested a metastatic lesion adjascent to an adrenal adenoma. CT-guided biopsy of the adrenal gland was consistent with small cell lung cancer metastasis. The patient underwent systemic chemotherapy and had complete resolution of the left upper lobe mass. Post-treatment FDG-PET demonstrated a persistently enlarged adrenal gland with decreased but persistent FDG uptake. The patient underwent adrenalectomy and pathologic examination demonstrated a small cell lung cancer/adenoma collision tumor.

CONCLUSIONS
This case and a review of the literature demonstrate that FDG, CT and MR imaging can characterize the separate components of collision tumors within the adrenal gland.