Abstract
Solid pseudopapillary tumor (SPT) is a rare low-grade malignant neoplasm originating predominantly in the pancreas. Extra-pancreatic SPTs are exceedingly rare clinical entities. The 18 F-FDG PET/CT imaging features of extra-pancreatic SPTs remain poorly characterized in the current literature. We present a diagnostically challenging case of left adrenal SPT demonstrating MRI and 18 F-FDG PET/CT features indistinguishable from adrenocortical carcinoma, ultimately resulting in preoperative misdiagnosis.