title: A case of non-functioning huge adrenocortical carcinoma extending into inferior vena cava and right atrium.
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.forename: Il Suk
authors.initials: IS
authors.lastname: Sohn
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Yun
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Cho
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Ik Joo
authors.initials: IJ
authors.lastname: Chung
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: 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*