A case of non-functioning huge adrenocortical carcinoma extending into inferior vena cava and right atrium.
Primary adrenocortical carcinoma (ACC) is a rare tumor and its usual sites of metastasis are the lung (71%), lymph node (68%), liver (42%), and bone (26%). However, intracaval invasion extending into the right atrium is very rare and spontaneous regression of tumor burden in adrenal carcinoma is also rare. We report a case of ACC with direct invasion of the inferior vena cava and right atrium. A 34-yr-old male patient presented with progressive dyspnea, weight loss, and poor oral intake over 3 months. Non-functioning ACC with direct invasion of the inferior vena cava and right atrium was confirmed by imaging, pathologic, and hormonal study. Chemo-radiotherapy was attempted. However, tumor burden was not changed, but rather toxic hepatitis and thrombocytopenia were developed. His subjective symptoms and general conditions were improved after 1 month of conservative management and the patient was discharged. During clinical follow-up, this tumor showed spontaneous regression.
Kim
Kye Hun
KH
Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
Park
Jong Chun
JC
Lim
Sang Yup
SY
Sohn
Il Suk
IS
Yun
Kyung Ho
KH
Cho
Sang Hee
SH
Hong
Young Joon
YJ
Park
Hyung Wook
HW
Kim
Ju Han
JH
Kim
Weon
W
Ahn
Young Keun
YK
Chung
Ik Joo
IJ
Jeong
Myung Ho
MH
Cho
Jeong Gwan
JG
Kang
Jung Chaee
JC
D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D018268:Adrenocortical Carcinoma / Q000175:diagnosis* / Q000473:pathology*; D000328:Adult; D001706:Biopsy; D004452:Echocardiography; D005500:Follow-Up Studies; D006325:Heart Atria / Q000473:pathology*; D006338:Heart Neoplasms / Q000473:pathology / Q000556:secondary*; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D012074:Remission Induction; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior / Q000473:pathology*