18F-Fluorocholine PET/CT is a valuable imaging tool in prostate cancer evaluation, especially for detecting biochemical recurrence. However, false-positive results, including benign adrenal adenomas, may occur. We present a case of a 62-year-old male with treated prostate cancer, who underwent 18F-FCH PET/CT due to biochemical recurrence. The scan showed focal uptake in the prostatic bed but also unexpectedly identified a 13x14 mm hypodense mass in the left adrenal gland. MRI suggested an adrenocortical adenoma, which was confirmed histologically. While adrenal radiotracer uptake is well-documented with other radiotracers, 18F-FCH role in characterizing adrenal lesions remains underexplored. This case raises the potential for 18F-FCH PET/CT to help distinguish benign from malignant adrenal tumors, warranting further investigation.

Keywords : adrenal adenoma, 18F-Fluorocholine, PET/CT, prostate cancer