case_images: PMC3779390_01
case_images: 40-year-old female with history of intermittent right flank pain and features of Cushing's syndrome diagnosed as having adrenocortical carcinoma with tumor thrombosis. CECT Abdomen shows a well-defined heterogeneously enhancing mass lesion in right suprarenal location (black arrow) with tumor thrombus in the IVC reaching up to the right atrium (white arrow).
case_images: JCIS-3-32-g002.jpg
case_images: PMC3779390_01_JCIS-3-32-g002.jpg
case_images: F1
case_images: On contrast enhanced computed tomography (CECT) abdomen there was a well-defined heterogeneously enhancing mass lesion 10 x 9 cm with necrotic areas in right suprarenal location with infiltration into the segment VI and V of the liver and tumor thrombus in the IVC reaching up to the right atrium [Figure 1].
case_images: 40-year-old female with history of intermittent right flank pain and features of Cushing's syndrome diagnosed as having adrenocortical carcinoma with tumor thrombosis. PET CT scan shows intense FDG uptake (SUV max 8.6) in the right suprarenal tumor (solid curved arrow) and the intracaval tumor thrombus (solid straight arrow).
case_images: JCIS-3-32-g003.jpg
case_images: PMC3779390_01_JCIS-3-32-g003.jpg
case_images: F2
case_images: Left adrenal gland was normal. positron emission tomography (PET CT) with computed tomography scan showed intense FDG uptake {standardized uptake values} (SUV) max 8.6) [Figure 2].
case_images: 40-year-old female with history of intermittent right flank pain and features of Cushing's syndrome diagnosed as having adrenocortical carcinoma with tumor thrombosis. Entire surgical specimen shows the adrenal tumor (solid twisted arrow) along with the tumor thrombus (solid straight arrow).
case_images: JCIS-3-32-g004.jpg
case_images: PMC3779390_01_JCIS-3-32-g004.jpg
case_images: F3
case_images: Specimen excised revealed complete removal of tumor with the thrombus [Figure 3].
case_images: 40-year-old female with history of intermittent right flank pain and features of Cushing's syndrome diagnosed as having adrenocortical carcinoma with tumor thrombosis. Photomicrograph of the adrenal tumor shows moderately differentiated tumor cells in sheet with bizarre nuclei (solid straight arrow) and intervening vessels (solid twisted arrow) (H and E, x100).
case_images: JCIS-3-32-g005.jpg
case_images: PMC3779390_01_JCIS-3-32-g005.jpg
case_images: F4
case_images: Histopathology of the specimen confirmed the diagnosis of adrenocortical carcinoma with tumor thrombosis [Figure 4].