Use of magnetic resonance imaging scanning in adrenocortical carcinoma with vena caval involvement

We report on 2 cases of an adrenocortical carcinoma with vena caval involvement. Preoperative evaluation included a magnetic resonance imaging (MRI) scan confirming the presence of vena caval involvement. Extremely precise detail of the vena caval tumor thrombus was very helpful in preparing for the surgical extirpation. MRI detail far outweighed what was seen on the computed tomography scan and venacavogram. The MRI scan correlated exactly with what was found surgically. Although MRI scanning has been used to evaluate renal tumors with vena caval extension, few cases have been reported with similar adrenal tumors.