We report a rare case of adrenal epithelioid angiosarcoma metastatic to the epicardium diagnosed by F-FDG PET/CT. A 61-year-old man presented with fatigue, unintentional weight loss, night sweats, and elevated inflammatory markers. FDG PET/CT demonstrated intense uptake in a space-occupying lesion in the right adrenal gland and increased uptake in a lesion adjacent to the heart. Histopathologic evaluation revealed an epithelioid angiosarcoma of the right adrenal gland metastatic to the epicardium. FDG PET/CT is a valuable tool for characterization and making the therapeutic decision concerning indeterminate or suspicious adrenal tumors.