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When prostate-specific antigen (PSA) was 31.66 ng\/mL, the lesion was not identified as a metastasis by <jats:sup>18<\/jats:sup>F-choline positron emission tomography\/computed tomography (<jats:sup>18<\/jats:sup>F-choline-PET\/CT). When PSA was over 100 ng\/mL, <jats:sup>18<\/jats:sup>F-choline-PET\/CT diagnosed the malignancy. After adrenalectomy, PSA returned to normal, and stable disease remission was obtained. 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