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下大静脈合併切除再建を要した右副腎癌の１例

青木, 諒介 清水, 明 窪田, 晃治 野竹, 剛 細田, 清孝 安川, 紘矢 林, 輝 副島, 雄二 信州大学

2022.04.13

概要

We report a case of right adrenal cortical carcinoma with tumor thrombus in the inferior vena cava (IVC), which was safely resected.

A 50-year-old woman was referred to our hospital for investigation of a right adrenal tumor,13 cm in di-ameter, with extension to the IVC. Preparing an artificial heart-lung machine, radical surgery, including resec¬tion of the tumor, part of the right liver lobe, and tumor thrombus in the IVC was performed. Surgery was safely performed without the aid of cardiopulmonary bypass. This was because we used intraoperative transe¬sophageal echocardiographic evaluation, which was able to confirm whether tumor invasion extended into the right atrium, and to detect the resection range of the IVC. Surgical resection was completed as usual without complications; the postoperative course was uneventful and the patient was discharged on postoperative day 16 with asymptomatic pulmonary thromboembolism. The patient was treated with mitotane (o,p'-DDD), which re¬sulted in necrosis of the adrenocortical tumor. The patient was alive 9 months after surgery. Shinshu Med J 70:107—117； 2022

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