Figure 2 SPECT/CT renal dynamic imaging. A . Arterial perfusion imaging: Both kidneys showed early arterial filling 2 seconds after the abdominal aorta became visible. Perfusion of the left kidney was normal, while perfusion of the right kidney was reduced.B. Renal dynamic imaging: Both kidneys were visualized, but the right kidney was significantly smaller in size compared to the left kidney, with a normal anatomical position. The left renal cortex demonstrated normal uptake and clearance rates of the tracer, while the right kidney showed reduced uptake and delayed clearance.
PET/CT: A round, mixed-density tumor was observed in the left renal hilum. Both 18-FDG and 18F-PSMA PET/CT scans showed increased radiotracer uptake, with a maximum standardized uptake value (SUVmax) of 6.6. No significant abnormalities were noted in other regions (Figure 3 ). Based on the PET/CT findings, the tumor at the left renal hilum is considered likely to be an ectopic adrenal adenoma.