Adrenal Epithelioid Angiosarcoma Metastatic to the Epicardium: Diagnosis by 18F-FDG PET/CTDerlin, Thorsten MD*; Clauditz, Till Sebastian MD†; Habermann, Christian Rolf MD*Clinical Nuclear Medicine: September 2012 - Volume 37 - Issue 9 - p 914–915 doi: 10.1097/RLU.0b013e318262af6b Interesting Images Abstract Author Information Article Outline We report a rare case of adrenal epithelioid angiosarcoma metasta-tic to the epicardium diagnosed by 18F-FDG PET/CT. A 61-year-old man presented with fatigue, unintentional weight loss, night sweats, and elevated inflammatory markers. FDG PET/CT demonstrated intense uptake in a space-occupying lesion in the right adrenal gland and increased uptake in a lesion adjacent to the heart. Histopathologic evaluation revealed an epithelioid angiosarcoma of the right adrenal gland metastatic to the epicardium. FDG PET/CT is a valuable tool for characterization and making the therapeutic decision concerning indeterminate or suspicious adrenal tumors. From the *Department of Diagnostic and Interventional Radiology and †Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Received for publication March 9, 2012; and revision accepted May 14, 2012. Conflicts of interest and sources of funding: none declared. Reprints: Thorsten Derlin, MD, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, D-20246 Hamburg-Eppendorf, Germany. E-mail: email@example.com. Abstract REFERENCES FIGURE 1 Back to Top | Article Outline REFERENCES1. Hart J, Mandavilli S. Epithelioid angiosarcoma: a brief diagnostic review and differential diagnosis. Arch Pathol Lab Med. 2011; 135: 268–272. 2. Meis-Kindblom JM, Kindblom LG. Angiosarcoma of soft tissue: a study of 80 cases. Am J Surg Pathol. 1998; 22: 683–679. 3. Ansquer C, Scigliano S, Mirallié E, et al.. 18F-FDG PET/CT in the characterization and surgical decision concerning adrenal masses: a prospective multicentre evaluation. Eur J Nucl Med Mol Imaging. 2010; 37: 1669–1678. 4. Perri M, Erba P, Volterrani D, et al.. Adrenal masses in patients with cancer: PET/CT characterization with combined CT histogram and standardized uptake value PET analysis. AJR Am J Roentgenol. 2011; 197: 209–216. 5. Boland GW, Dwamena BA, Jagtiani Sangwaiya M, et al.. Characterization of adrenal masses by using FDG PET: a systematic review and meta-analysis of diagnostic test performance. Radiology. 2011; 259: 117–126. 6. Kumar R, Shamim SA, Shandal V, et al.. FDG PET/CT in detection of adrenal metastasis in patients with renal cell carcinoma. Clin Nucl Med. 2011; 36: 513–517. 7. Roudaut N, Malecot JM, Dupont E, et al.. Adrenal tuberculosis revealed by FDG PET. Clin Nucl Med. 2008; 33: 821–823. 8. Sibille L, Ilonca D, Oziol E, et al.. FDG PET/CT in aortic angiosarcoma. Clin Nucl Med. 2010; 35: 134–137. Keywords:angiosarcoma; cardiac; pericardial; metastasis; 18F-FDG; PET/CT © 2012 Lippincott Williams & Wilkins, Inc.