Carcinoma of the adrenal cortex is a rare tumour. The incidence of vena cava involvement may be present in 15 to 20% of patients. The intra caval tumour thrombus can attain the right atrium. Even if some authors consider these lesions as a metastasis, long-term survival can be obtained after radical resection. The surgical tactical depend on the extension of thrombus into the vena cava inferior. The authors report a case with 4 years survival without recurrence after surgical treatment.
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