Journal of Korean Medical Science  2006;21(3):572-576

doi:10.3346/jkms.2006.21.3.572

A Case of Non-Functioning Huge Adrenocortical Carcinoma Extending Into Inferior Vena Cava and Right Atrium.

Kye Hun KIM 1 ; Jong Chun PARK ; Sang Yup LIM ; Il Suk SOHN ; Kyung Ho YUN ; Sang Hee CHO ; Young Joon HONG ; Hyung Wook PARK ; Ju Han KIM ; Weon KIM ; Young Keun AHN ; Ik Joo CHUNG ; Myung Ho JEONG ; Jeong Gwan CHO ; Jung Chaee KANG

Affiliations

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Keywords

Adrenocortical Carcinoma; Neoplasm Metastasis; Vena Cava, Inferior

Country

Republic of Korea

Language

English

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.