[Left adrenal carcinoma with caval thrombosis].
OBJECTIVE
To review the epidemiology, classification, prognosis, and therapeutic options of adrenal cortical carcinoma, mainly those of functional tumors.


RESULTS
52-year-old male presenting with wasting syndrome and a big left adrenal tumor, as well as a possible inferior vena cava thrombus. The tumor was catalogued as non functional after functional studies. Surgical intervention was carried out including adrenal tumor excision, splenectomy, and cavotomy with thrombectomy of a tumoral thrombus coming from the left adrenal and renal veins. Infrarenal iliocaval thrombosis appeared during the postoperative period, requiring intensive anticoagulant therapy and ICU admission for control. Pathological diagnosis confirmed the existence of a high grade malignant adrenal cortical carcinoma. Patient died two months after surgery due to disease progression.


CONCLUSIONS
Radiological tests are fundamental in the diagnosis of adrenal masses. In the case of big tumoral masses, it is important to rule out the existence of possible tumor thrombi in the adrenal vein territory, including the inferior vena cava.
Ortiz Gorraiz
Manuel
M
Servicio de Urología, Hospital Universitario Virgen de las Nieves, Granada, España. mortig@fundacionhvn.org
Tallada Buñuel
Miguel
M
Vicente Prados
Francisco Javier
FJ
Rodríguez Herrera
Francisco
F
Rosales Leal
José Luis
JL
Honrubia Vílchez
Beatriz
B
Martínez Morcillo
Antonio
A
Cózar Olmo
José Manuel
JM
Espejo Maldonado
Eduardo
E
D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D002277:Carcinoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009392:Nephrectomy; D011183:Postoperative Complications / Q000209:etiology; D013154:Spleen / Q000473:pathology; D013156:Splenectomy; D013927:Thrombosis / Q000209:etiology*; D014682:Vena Cava, Inferior / Q000473:pathology*; D020246:Venous Thrombosis / Q000209:etiology