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Malignancy of the adrenal cortex is uncommon but aggressive and grows rapidly and metastasizes to the liver, lungs, kidneys, and bones. Very rarely, tumor thrombus may extend through via adrenal vein to the inferior vena cava (IVC) and even may extend up to the right atrium. Such a scenario is rare and possesses a real surgical challenge. We present a case of right adrenocortical tumor with IVC thrombus extending until the right atrium. The patient successfully underwent right adrenalectomy with nephrectomy and retroperitoneal lymphadenectomy and removal of its intravascular extension with the assistance of cardiopulmonary bypass and intraoperative transesophageal echocardiography. 1,2Assistant Professor, 3-6Professor 1Department of Urology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India 2,6Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India 3,4Department of CVTS, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India 5Department of Anesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India Corresponding Author: Sureka S Kumar, Assistant Professor Department of Urology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, Phone: +918004904749, e-mail: drsksureka@gmail.com ENDOCRINE IMAGE 10.5005/jp-journals-10002-1225 wjOEs

Adrenocortical Carcinoma with Inferior Vena Cava Thrombus extending up to Right Atrium: Evaluation and Management