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  Indian J Med Microbiol
 

Figure 2: Patient 1 (a-d): A 37-year-old male, a diagnosed case of adrenocortical carcinoma, underwent fluoro-2-deoxyglucose-positron emission tomography–computed tomography for staging. Maximum intensity projection image (a) showed fluoro-2-deoxyglucose avidity in the primary lesion in the right adrenal gland (black arrow) and multiple foci of fluoro-2-deoxyglucose avidity in the lung region (white arrow) which was secondary to infective infiltrates in the lung. Transaxial positron emission tomography (b) was showing a focus of increased fluoro-2-deoxyglucose avidity (black arrow) which localized to a subcentimetric retrocaval lymph node which was negative for metastasis in the computed tomography component (c) but the fused positron emission tomography–computed tomography (d) images showed focal fluoro-2-deoxyglucose avidity in the lymph node which altered the management to include adjuvant radiotherapy. Patient 2 (e-h): A 50-year-old female underwent fluoro-2-deoxyglucose-positron emission tomography–computed tomography for restaging (e) following surgical resection of left adrenal adrenocortical carcinoma, which showed a faintly fluoro-2-deoxyglucose avid lesion (black arrow) in the left infrasplenic region which was suspicious for metastatic deposit on computed tomography (f) but negative according to fluoro-2-deoxyglucose-positron emission tomography–computed tomography (g). The fluoro-2-deoxyglucose-positron emission tomography–computed tomography done for surveillance after 2 years (h) showed no change in the lesion confirming its benign nature. Fluoro-2-deoxyglucose-positron emission tomography–computed tomography helped in changing the management from local radiotherapy to observation alone

Figure 2: Patient 1 (a-d): A 37-year-old male, a diagnosed case of adrenocortical carcinoma, underwent fluoro-2-deoxyglucose-positron emission tomography–computed tomography for staging. Maximum intensity projection image (a) showed fluoro-2-deoxyglucose avidity in the primary lesion in the right adrenal gland (black arrow) and multiple foci of fluoro-2-deoxyglucose avidity in the lung region (white arrow) which was secondary to infective infiltrates in the lung. Transaxial positron emission tomography (b) was showing a focus of increased fluoro-2-deoxyglucose avidity (black arrow) which localized to a subcentimetric retrocaval lymph node which was negative for metastasis in the computed tomography component (c) but the fused positron emission tomography–computed tomography (d) images showed focal fluoro-2-deoxyglucose avidity in the lymph node which altered the management to include adjuvant radiotherapy. Patient 2 (e-h): A 50-year-old female underwent fluoro-2-deoxyglucose-positron emission tomography–computed tomography for restaging (e) following surgical resection of left adrenal adrenocortical carcinoma, which showed a faintly fluoro-2-deoxyglucose avid lesion (black arrow) in the left infrasplenic region which was suspicious for metastatic deposit on computed tomography (f) but negative according to fluoro-2-deoxyglucose-positron emission tomography–computed tomography (g). The fluoro-2-deoxyglucose-positron emission tomography–computed tomography done for surveillance after 2 years (h) showed no change in the lesion confirming its benign nature. Fluoro-2-deoxyglucose-positron emission tomography–computed tomography helped in changing the management from local radiotherapy to observation alone