Benign pure androgen-secreting adrenal tumor misdiagnosed as adrenocortical carcinoma on ¹⁸F-FDG PET-CT: a rare case report

Background: Adult pure androgen-secreting adrenal tumors (PASATs) are rarely reported and the malignancy of such tumor are difficult to confirm before surgery. Here we report a PASAT demonstrating extremely ¹⁸F-FDG uptake turned out to benign tumor by postoperative pathology examination.

Case presentation: A 19-year-old adolescent found a tumor measuring 7.2 cm located in the right adrenal region on enhanced CT during the routine physical examination. Signs of virilization and elevated testosterone and dehydroepiandrosterone (DHEA) were verified during preoperative examination. ¹⁸F-FDG PET/CT revealed the tumor had an extremely high ¹⁸F-FDG uptake with a SUVmax reaching 42.7, which turned out to be oncocytic adrenocortical adenoma by pathological examination.

Conclusions: ¹⁸F-FDG PET/CT may be limited in assessing the malignancy of PASAT.