Oncocytic Adrenocortical Carcinoma with Low 18F-FDG Uptake and the Absence of Glucose Transporter 1 Expression

Naru Babaya, Shinsuke Noso, Yoshihisa Hiromine, Yasunori Taketomo, Fumimaru Niwano, Keisuke Monobe, Shuzo Imamura, Kazuki Ueda, Yuto Yamazaki, Hironobu Sasano, Hiroshi Ikegami

Research output: Contribution to journalArticlepeer-review


Adrenocortical carcinoma (ACC) is a rare tumor, and some histological variants (oncocytic, myxoid, and sarcomatoid ACCs) have been reported in addition to the conventional ACC. Among these subtypes, oncocytic ACC is histologically characterized by the presence of abundant eosinophilic granular cytoplasm in the carcinoma cells owing to the accumulation of mitochondria, which generally yields high 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET). Herein, we report the case of a 21-year-old woman with oncocytic ACC with low FDG uptake on PET scan. Her circulating levels of androgens were high, and androgen-synthesis enzymes were detected in carcinoma cells. The patient also had hypocholesterolemia. However, glucose transporter 1 (GLUT1) was not detected in the tumor, which was considered to account for the low FDG uptake by the tumor. To the best of our knowledge, this is the first case of low FDG uptake by oncocytic ACC without GLUT1 expression. Additionally, since hypocholesterolemia was reported in 3 previous reports of androgen-producing tumors, a possible correlation between androgenicity in adrenal tumors and the development of hypocholesterolemia could be postulated; however, further investigations are needed for clarification. This case highlights important information regarding the diversity of ACC and its impact on hypocholesterolemia.

Original languageEnglish
Article numberbvab143
JournalJournal of the Endocrine Society
Issue number11
Publication statusPublished - 2021 Nov 1


  • adrenal incidentaloma
  • androgen
  • cholesterol
  • DHEA-S
  • SUVmax

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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