title: Adrenocortical Carcinoma With Renal Vein Thrombus Extended to Inferior Vena Cava: A Case Report.
abstract: Adrenocortical carcinoma (ACC) is a rare aggressive tumor. Renal vein and inferior vena cava (IVC) thrombi have been found as uncommon presentations of ACC; however, the implementation of comprehensive therapy has remained controversial in such cases. We report a case of a 46-year-old woman with a large ACC associated with the invasion of tumor to IVC confirmed by imaging and immunohistochemistry examinations. The patient was treated successfully using aggressive surgery, including adrenalectomy and thrombectomy adjunct to an adrenocorticolytic agent. However, she died of metastasis complications at 3-month follow-up period. ACC is a rare malignancy, mostly presenting in advanced stages with poor prognosis. Implementing aggressive surgical therapy might be effective for the management of such cases; however, the short survival duration in our case underscores the need for defining the precise therapy of metastatic ACC associated with venous invasion.
authors.affiliation: 1 Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ayati
authors.affiliation: 1 Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Jafar
authors.initials: J
authors.lastname: Shahbazi
authors.affiliation: 2 Urmia Urology and Nephrology Research Center and.
authors.forename: Ali
authors.initials: A
authors.lastname: Tehranchi
authors.affiliation: 1 Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Elnaz
authors.initials: E
authors.lastname: Ayati
authors.affiliation: 3 Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Rezaei
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D000315:Adrenalectomy; D018268:Adrenocortical Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009392:Nephrectomy; D012082:Renal Veins / Q000473:pathology*; D013927:Thrombosis / Q000209:etiology*; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000473:pathology*
keywords: Adrenalectomy; Adrenocortical carcinoma; Distant metastasis; Inferior vena cava thrombus