The present results of high PSMA expression in primary, recurrent and metastatic tumour cells with limited spatial and temporal variability, as well as the uptake of PSMA ligand in recurrent and distant metastatic AdCC on PET/CT, could suggest a potential role for palliative targeted treatment with Lutetium-177-PSMA [10, 32]. This evidence concerns the gene FOLH1 and adrenocortical carcinoma, hereditary.