Adrenocortical Carcinoma With Renal Vein Thrombus Extended to Inferior Vena Cava: A Case Report

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