Kim Kye Hun, Park Jong Chun, Lim Sang Yup, Sohn Il Suk, Yun Kyung Ho, Cho Sang Hee, Hong Young Joon, Park Hyung Wook, Kim Ju Han, Kim Weon, Ahn Young Keun, Chung Ik Joo, Jeong Myung Ho, Cho Jeong Gwan, Kang Jung Chaee
Department of Cardiovascular Medicine, Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.
J Korean Med Sci. 2006 Jun;21(3):572-6. doi: 10.3346/jkms.2006.21.3.572.
Primary adrenocortical carcinoma (ACC) is a rare tumor and its usual sites of metastasis are the lung (71%), lymph node (68%), liver (42%), and bone (26%). However, intracaval invasion extending into the right atrium is very rare and spontaneous regression of tumor burden in adrenal carcinoma is also rare. We report a case of ACC with direct invasion of the inferior vena cava and right atrium. A 34-yr-old male patient presented with progressive dyspnea, weight loss, and poor oral intake over 3 months. Non-functioning ACC with direct invasion of the inferior vena cava and right atrium was confirmed by imaging, pathologic, and hormonal study. Chemo-radiotherapy was attempted. However, tumor burden was not changed, but rather toxic hepatitis and thrombocytopenia were developed. His subjective symptoms and general conditions were improved after 1 month of conservative management and the patient was discharged. During clinical follow-up, this tumor showed spontaneous regression.
原发性肾上腺皮质癌（ACC）是一种罕见肿瘤，其常见转移部位为肺（71%）、淋巴结（68%）、肝（42%）和骨（26%）。然而，下腔静脉侵犯延伸至右心房的情况非常罕见，肾上腺皮质癌肿瘤负荷的自发消退也很罕见。我们报告一例直接侵犯下腔静脉和右心房的ACC病例。一名34岁男性患者在3个月内出现进行性呼吸困难、体重减轻和食欲减退。通过影像学、病理学和激素检查确诊为无功能ACC并伴有下腔静脉和右心房的直接侵犯。尝试进行了放化疗。然而，肿瘤负荷未改变，反而出现了中毒性肝炎和血小板减少症。经过1个月的保守治疗，患者的主观症状和一般状况有所改善，随后出院。在临床随访期间，该肿瘤出现了自发消退。
