Adrenal collision tumors and their mimics: Multimodality imaging findings

Venkata S. Katabathina, Erin Flaherty, Ravi Kaza, Vijayanadh Ojili, Kedar N. Chintapalli, Srinivasa R. Prasad

Research output: Contribution to journalReview articlepeer-review

31 Scopus citations


Adrenal collision tumors (ACTs) refer to coexistence of two adjacent, but histologically distinct neoplasms involving the adrenal gland without histologic admixture at interface. ACTs include adenoma with myelolipoma, adenoma with metastases, hemangioma with adenoma, and adrenocortical carcinoma with myelolipoma. In addition, hemorrhage into a pre-existing adrenal mass can mimic an ACT, and it is important to differentiate these two pathologies. Accurate characterization of ACTs is difficult, but critical, for correct staging of patients with malignancies and to guide percutaneous biopsy. Magnetic resonance imaging (MRI) and multidetector computed tomography imaging techniques may depict different tumor components separately; however, biopsy may be required in selected patients for confirmation. [18F]Fluorodeoxyglucose-positron emission tomography (PET) shows increased uptake in the malignant component of ACTs, and guides percutaneous biopsy. Even in patients requiring percutaneous biopsy for a definite diagnosis, imaging findings can help in guiding the appropriate component to be biopsied. Knowledge of imaging findings of different ACTs and their mimics on MRI, computed tomography, and PET help in optimal patient management.

Original languageEnglish (US)
Pages (from-to)602-610
Number of pages9
JournalCancer Imaging
Issue number4
StatePublished - Dec 30 2013


  • Adrenal collision tumors
  • Magnetic resonance imaging
  • Multidetector computed tomography
  • Positron emission tomography/computed tomography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Oncology
  • Radiology Nuclear Medicine and imaging


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