Adrenal cortical carcinoma associated with venous tumour thrombus extension.

Abstract

To report the diagnosis and treatment of six patients with adrenocortical adenocarcinoma and venous tumour thrombus extension. All six patients (four female and two male, age range 14-83 years) were approached surgically through a thoracoabdominal incision and all underwent radical ablative surgery with removal of the primary tumour, regional retroperitoneal lymphadenectomy and en bloc extraction of the venous tumour thrombus. Five patients with right-sided tumours had vena caval tumour thrombus involvement and one patient with a left-sided tumour had extension of tumour thrombus into the splenic vein. All patients had appropriate radiographic evaluation pre-operatively and all underwent successful radical surgery with en bloc resection of the venous tumour thrombus. For optimal management of this rare neoplasm, it is paramount that accurate diagnostic imaging be performed pre-operatively to help dictate the ideal surgical approach and to optimize successful treatment of this disease.