Extension of adrenocortical carcinomainto the right atrium

Adrenocortical carcinoma [ACC] is a rare and highly aggressive malignant neoplasm which can produce intravascular extension into the inferior vena cava [IVC] rarely extend into the right atrium [RA]. We report a case of a male patient with large ACC with extension into the IVC and RA. Computed tomography showed a large right adrenal mass with contiguous tumor thrombus extending into IVC and RA with extension to the level of tricuspid valve. Patient underwent combined cardiac and abdominal surgical intervention on cardiopulmonary bypass with removal of the mass