Purpose: Adrenal venous sampling (AVS) is recommended for subtyping primary aldosteronism (PA). However, in cases of PA, concurrent subclinical Cushing's syndrome (SCS) has the potential to confound AVS results. Pentixafor, a CXC chemokine receptor type 4-specific ligand, has been reported as a promising marker to evaluate functional nature of adrenal adenomas. This study aims to investigate the clinical value of Gallium-68 Pentixafor Positron Emission Tomography-Computed Tomography (Ga-Pentixafor PET/CT) in the localization diagnosis of patients with PA plus SCS.
Methods: Two patients with a confirmed diagnosis of PA plus SCS underwent AVS and Ga-Pentixafor PET/CT.
Results: AVS results revealed no lateralization for both patients while Ga-Pentixafor PET/CT showed a unilateral adrenal nodule with increased uptake of Ga-Pentixafor. Unilateral adrenalectomy was performed based on the results of Ga-Pentixafor PET/CT. Subsequently, complete biochemical remission of autonomous aldosterone and cortisol secretion were achieved in both cases.
Conclusions: Ga-Pentixafor PET/CT shows promising potential for the localization of aldosterone and cortisol co-secreting adrenal adenoma in patients with PA plus SCS.
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