Iodocholesterol adrenal scanning for the detection of adrenal metastases in lung cancer and its clinical significance.

Detection of adrenal metastases is difficult. Since metastatic growth fails to destroy sufficient adrenal tissue to produce clinical symptoms of adrenal insufficiency, and since adrenal metastases have been reported in 28--36% of autopsied patients with primary lung cancer, the authors studied 25 patients with lung cancer by using iodocholesterol adrenal scans. Six patients (24%) were found to have abnormal scans suggestive of adrenal metastases by this technique. Two of these patients were confirmed by biopsy to have adrenal metastases. Four of the six patients died within a mean of six weeks of the positive scan. Iodocholesterol adrenal scanning appears to be a promising noninvasive technique in the detection of adrenal metastases. The prognostic significance of adrenal metastases is discussed.