Rapid extension of left adrenocortical carcinoma into the right atrium

Adrenocortical carcinoma is a rare tumor which can extend into the right heart via the inferior vena cava. We describe a case of a 26-year-old woman who had progressive shortness of breath, intermittent chest pain, and peripheral edema. A two-dimensional echocardiogram on hospital admission showed a large multinodular mass in the right atrium which extended into the inferior vena cava. Further studies showed that this mass was adrenocortical carcinoma. An echocardiogram performed 3 weeks before admission was completely normal. It appears that an adrenocortical carcinoma is capable of rapid growth up the inferior vena cava and into the right atrium.