Mezhir James J, Song Jie, Piano Giancarlo, Testa Guiliano, Raman Jaishankar, Al-Ahmadie Hikmat A, Angelos Peter
Department of Surgery, Sections of General Surgery, University of Chicago Medical Center, Chicago, IL 60637, USA.
Endocr Pract. 2008 Sep;14(6):721-5. doi: 10.4158/EP.14.6.721.
To present the case of a man with a right-sided adrenocortical carcinoma that invaded the inferior vena cava and was managed by radical resection and vein patch repair.
We report the clinical, laboratory, imaging, and operative findings, and we highlight the pertinent features of this case. The literature is reviewed for the management of adrenocortical carcinoma in conjunction with inferior vena cava invasion.
In a 34-year-old man with new-onset abdominal pain, abdominal imaging disclosed a large right adrenal mass with invasion into the inferior vena cava. Laboratory values revealed that the adrenal mass was likely nonfunctional. At surgical intervention with use of cardiopulmonary bypass, the mass was removed en bloc with the adrenal gland, right kidney, and the wall of the inferior vena cava, and the inferior vena cava was reconstructed with bovine pericardium.
Despite direct invasion or extension of tumor thrombus into the inferior vena cava (or both), complete (R0) resection can be obtained. Thus, this scenario should not preclude attempted curative resection in patients with adrenal cancer.
介绍一例右侧肾上腺皮质癌侵犯下腔静脉并接受根治性切除及静脉补片修复治疗的病例。
我们报告临床、实验室、影像学及手术 findings，并突出该病例的相关特征。回顾文献中肾上腺皮质癌合并下腔静脉侵犯的治疗方法。
一名34岁新发腹痛男性，腹部影像学检查发现右侧肾上腺有一巨大肿块，侵犯下腔静脉。实验室检查结果显示肾上腺肿块可能无功能。在使用体外循环的手术干预中，肿块与肾上腺、右肾及下腔静脉壁整块切除，下腔静脉用牛心包重建。
尽管肿瘤直接侵犯或肿瘤血栓延伸至下腔静脉（或两者皆有），仍可实现完整（R0）切除。因此，这种情况不应排除对肾上腺癌患者进行根治性切除的尝试。
