Oedema and thoracoepigastric vein dilation on bilateral legs: adrenal gland tumour with inferior vena cava tumour thrombus

Description

An 86-year-old man presented with a 1-month history of progressive oedema of both legs. His medical history included stage IV non-small cell lung cancer (adenocarcinoma) with mediastinal lymph node metastasis, and he had been on cisplatin and gemcitabine for 1 year. Physical examination revealed oedema of lower extremities and dilation of the thoracoepigastric vein (figure 1). A right upper quadrant mass was palpated. Contrast-enhanced CT revealed a 61x65 mm adrenal gland tumour with a heterogeneous and irregular margin, along with an inferior vena cava (IVC) tumour thrombus extending into the right atrium (figure 2). His adrenal gland function was normal. Percutaneous biopsy of the right mass revealed adenocarcinoma. We clinically diagnosed the tumour as adrenal metastasis from lung cancer.

Figure 1

Dilation of thoracoepigastric vein.

Figure 2

Contrast-enhanced CT revealed an adrenal gland tumour with inferior vena cava tumour...

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