FDG-avid left adrenal lesion with numerous malignant FDG avid lymph nodes surrounding both adrenal glands near the upper abdominal aorta and IVC. No evidence of metastatic disease elsewhere.
The most likely aetiology was considered bilateral adrenal metastases with metastatic lymph nodes in the upper abdomen, but a primary malignancy was not identified.
Synchronous primary adrenal carcinomas with adjacent metastatic nodes was considered possible.