Interdisciplinary treatment of large adrenocortical carcinoma infiltrating inferior vena cava

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Background: Adrenal tumors are common neoplasms and majority of them are small, benign, hormonally inactiveadrenocortical adenomas.Whereas adrenal cancer is a rarely occurring (5% of adrenal tumors) but highly aggressive neoplasm.The early diagnosis and complete surgical resection is the only effective treatment option.Laparoscopic adrenalectomy is the gold standard for small and medium tumors.Whereas for large tumors classic adrenalectomy is considered a procedure of choice with a proven better oncological outcome.Material and methods: There were 245 patients with adrenal tumors operated in the Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk, Poland between 2014and 2018.Results: Out of entire series, there was one case of a 57-year-old female diagnosed with a large, advanced left adrenal tumor with invasion of vena cava.It was diagnosed in computer tomography and proven in core biopsy.Open adrenalectomy with thoracotomy was conducted to completely resect the tumor by the interdisciplinary team.Conclusions: In case of large adrenal tumour with vessel infiltration, a successful R0 resection can be performed by multi-specialist approach.For adrenal cancer early diagnosis based on the clinical, biochemical and imaging features and successful surgical treatment is crucial in significant prolongation of patient survival.

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