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Updated: Apr 15, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Adrenocortical carcinoma and sudden death
Drew T Marshall1, John D Gilbert, Roger W Byard
1Forensic Science SA, 21 Divett Place, 5000, Adelaide, Australia.
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.
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