title: Surgical resection of a virilizing adrenal mass with extensive tumor thrombus.
abstract: Adrenocortical carcinoma with tumor thrombus and concomitant testosterone production is a rare entity. We describe a case of a 53-year-old woman with a testosterone producing left-sided adrenocortical carcinoma with tumor extending to the right atrium and tumor embolus to the right pulmonary artery. To our knowledge, there exist no such reported cases in the medical literature. We describe our use of techniques derived from transplant surgery for the removal of this mass. Critical components for successful resection included early renal artery ligation, hepatic mobilization off the inferior vena cava, and minimization of cardiopulmonary bypass time thus eliminating the need for deep hypothermic circulatory arrest.
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Florida 33101, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gahan
authors.forename: Samir P
authors.initials: SP
authors.lastname: Shirodkar
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gorin
authors.forename: Tomas A
authors.initials: TA
authors.lastname: Salerno
authors.forename: Gaetano
authors.initials: G
authors.lastname: Ciancio
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000601:surgery*; D018268:Adrenocortical Carcinoma / Q000453:epidemiology* / Q000378:metabolism / Q000601:surgery*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D008875:Middle Aged; D008939:Mitotane / Q000627:therapeutic use; D013739:Testosterone / Q000378:metabolism*; D013927:Thrombosis / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013739:Testosterone; D008939:Mitotane