18F-Fluorodeoxy glucose (FDG) uptake in nontraumatic bilateral adrenal hemorrhage secondary to heparin-associated thrombocytopenia syndrome (HATS)—a case report

18F-Fluorodeoxy glucose (FDG) activity reflects tissue glucose metabolism; malignancies, metastases, and acute infections have relatively increased FDG activity reflecting increased glucose metabolism. Benign adrenal disease demonstrating mild FDG uptake can be worrisome for metastasis in patients with a history of malignancy. Our patient with breast and colon cancer developed gastrointestinal bleeding on heparin therapy, enlarged adrenals with heterogeneous attenuation consistent with hemorrhage and blood clots as seen on abdominal computed tomography scan, and as abnormal intense FDG activity in the bilateral adrenal glands on positron emission tomography scan.