A Case of Right Adrenocortical Carcinoma Performed Adrenalectomy, Combined Liver Resection, Combined Resection of IVC and Removal of Tumor Emboli

Abstract

Adrenocortical carcinomas are extremely rare, with an incidence of 0.9 - 2.9 cases per million people. The disease has already invaded the liver and the inferior vena cava (IVC) at the time of diagnosis in some cases, however, there are some long-term surviving cases with complete resection. In this paper we report a case of complete resection of adrenocortical carcinoma by performing combined liver resection, and resection of IVC and reconstruction in a partial extracorporeal circulation blood circuit.

A 58-year-old man presented with right lateral abdominal pain. Following close examinations, the patient was diagnosed with liver invasion of right adrenal carcinoma, tumor embolism of the IVC, cT4N0M0, stage III. We performed right adrenalectomy, S6 subsegmentectomy of the liver, cholecystectomy, IVC resection and reconstruction, His postoperative course was uneventful and he was discharged from our hospital on 13 POD. The histopathological diagnosis was adrenal carcinoma with invasion to the IVC. No direct invasion to the liver was seen, but we could not avoid combined resection of the liver judging from the preoperative examinations.

We present a case of right adrenocortical carcinoma in which we performed adrenalectomy, combined liver resection, combined resection of the IVC, removal of tumor emboli and reconstruction in a partial extracorporeal circulation blood circuit.