63 year old male with melanoma metastasis to the right adrenal, candidate for right adrenalectomy.
A. Right adrenal metastasis appears as a solitary lesion on contrast-enhanced CT (arrow)
B. Preoperative PET-CT shows right adrenal metastasis (long arrow) and an unexpected gastric metastasis (short arrow).
C. Axial fused PET-CT image shows abnormal focal FDG uptake in the stomach (arrow).
D. No abnormality is evident in the gastric wall on contrast enhanced CT.
E. Gastric metastasis confirmed on endoscopy. The surgical plan changed to adrenalectomy and partial gastrectomy after neoadjuvant chemotherapy.