Adrenocortical Carcinoma With Intracaval Extension to the Right Atrium: Resection on Cardiopulmonary Bypass
Ryan Z. Swan*, Kwan N. Lau, David Sindram, David a. Iannitti, John B. Martinie
Surgery, Carolinas Medical Center, Charlotte, NC
Resection of advanced adrenocortical carcinoma is the only potentially curative treatment option. A 28 year-old female presents with dyspnea on exertion and is found to have a large (19 x 18cm) right adrenal mass invading the liver and inferior vena cava (IVC) with tumor thrombus extending into the right atrium. While on cardiopulmonary bypass, the patient underwent tumor resection, extraction of tumor thrombus from the IVC and right atrium, and partial hepatectomy. The abdomen was closed with a temporary closure device then closed primarily the following day. The patient was extubated on post-operative day 3, discharged home on day 12, and is undergoing adjuvant chemoradiation.
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