Both positron emission tomography/computed tomography (CT) and adrenal washout studies are highly accurate in differentiating benign from malignant adrenal lesions. Very few data exist to help guide management when the positron emission tomography and CT adrenal findings contradict each other with regard to the malignant potential. We present a patient with a remote history of breast cancer and a new solitary left adrenal mass. A CT washout study suggested a lipid-poor adenoma; however, positron emission tomography/CT demonstrated intense fluorodeoxyglucose uptake, suggesting malignancy. The pathologic evaluation after laparoscopic adrenalectomy revealed a benign adrenal adenoma.