CXCR4—A Potential Novel Theranostic Target in Adrenocortical Carcinoma

Adrenocortical carcinoma (ACC) is a highly aggressive malignancy with high recurrence rates and poor prognosis. There are only limited treatment options with poor response rates. ACCs are documented to express chemokine receptor CXCR4, which can be visualized using 68 Ga-pentixafor PET/CT. We herein present a case of ACC with local recurrence and peritoneal metastases, which was well visualized on FDG and pentixafor PET/CT. The high expression of CXCR4 offers the potential of theranostics and targeted endoradiotherapy in patients with metastatic ACC. We also observed thymic rebound to illustrate mild to moderate grade uptake of 68 Ga-pentixafor in this patient.