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Percutaneous Ethanol Ablation of an Adrenal Tumor

Daniel D. Maki1, Ziv J. Haskal1,2, Alexander Matthies1, Jill Langer1, Harvey L. Nisenbaum1, David Vaughn3 and Abass Alavi1

1 Department of Radiology, One Silverstein Bldg., Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
2 Present address: Division of Vascular and Interventional Radiology, MHB 4-100, New York Presbyterian Hospital-Columbia, 177 Fort Washington Ave., New York, NY 10032.
3 Department of Medicine, Hematology/Oncology Division, University of Pennsylvania Medical Center, Philadelphia, PA 19104.



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  		Fig. 1A. —78-year-old woman with weight loss and elevated serum cortisol level. Contrast-enhanced CT obtained before treatment reveals 11-cm left adrenal mass that contains central hypoattenuation and scattered hypervascular components.

 


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  		Fig. 1B. —78-year-old woman with weight loss and elevated serum cortisol level. Contrast-enhanced CT after percutaneous ethanol ablation shows tumor to be smaller than in A. Note central gas formation.

 


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  		Fig. 1C. —78-year-old woman with weight loss and elevated serum cortisol level. Axial (C) and coronal (D) FDG PET scans reveal photopenic defect (arrows) corresponding to left adrenal mass, compatible with near absent metabolic activity, suggesting substantial tumor cell death after ethanol ablation.

 


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  		Fig. 1D. —78-year-old woman with weight loss and elevated serum cortisol level. Axial (C) and coronal (D) FDG PET scans reveal photopenic defect (arrows) corresponding to left adrenal mass, compatible with near absent metabolic activity, suggesting substantial tumor cell death after ethanol ablation.

 

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