title: Adrenocortical carcinoma and sudden death.
abstract: A 26-year-old man who presented with a 2-year history of intermittent gynecomastia with recent onset of fever, night sweats, and abdominal distension was found to have a left-sided adrenocortical carcinoma with metastases to the liver and spine. Sudden death occurred 1 month after his presentation. At autopsy a saddle pulmonary thromboembolus was found occluding the pulmonary outflow tract, with smaller more peripheral pulmonary thromboemboli. No tumor deposits were identified in the thromboemboli. The thromboemboli had arisen from a tongue of tumor that had grown through the left adrenal vein into the inferior vena cava. Despite a high rate of angio-invasion there are very few reports of sudden death resulting from this phenomenon in patients with adrenocortical carcinoma.
authors: Forensic Science SA, 21 Divett Place, 5000, Adelaide, Australia.
authors: Drew T
authors: DT
authors: Marshall
authors: John D
authors: JD
authors: Gilbert
authors: Roger W
authors: RW
authors: Byard