Right atrial and ventricular invasion by adrenal carcinoma: A case report

Adrenocortical carcinomas (ACC) are rare but highly aggressive neoplasms. Intra-cardiac involvement with ACC is extremely rare and usually develops by intravascular invasion through the inferior vena cava (IVC). Complete surgical resection remains the most effective treatment. ACC prognosis is poor with a five-year overall survival rate of ∼35%. The poor prognosis may be related to the advanced stage at which the majority of adrenal carcinomas are detected. We encountered a 52-year-old male patient with a huge right adrenal mass with a tumor thrombus invading the IVC towards the right atrium and another tumor mass present in the right ventricle below the tricuspid valve. A whole-body scan revealed metastases everywhere. The patient started palliative chemotherapy and radiotherapy. Later, during a debulking surgery of the tumor with cardiopulmonary support the patient died. <Learning objective: Adrenocortical carcinomas (ACC) are rare highly aggressive neoplasms. Intra-cardiac involvement with ACC is extremely rare and usually develops by intravascular invasion through the inferior vena cava. The prognosis is usually poor due to delayed presentation and diagnosis and difficult management options.>.