Involvement of the inferior caval vein in adrenal metastasis.

A patient was referred to our hospital for resection of a large renal cell carcinoma with invasion of the inferior caval vein, diagnosed as such with CT, angiography and cavography. The history mentioned partial resection of the left lung for lung carcinoma 16 months before. At operation the tumor could not be removed, the patient died because of postoperative pulmonary complications. Autopsy and histopathological examination revealed a large metastatic tumor of the previous lung carcinoma in the left adrenal gland. The clinical implications and some diagnostic methods are discussed.