一位三十歲女性腎上腺皮質癌合併下腔靜脈與右心房腫瘤栓塞患者。雖然預後不佳，但為使病人免於猝死，我們藉由心肺體外循環機之助，為病人進行手術。術後，病人症狀與血清睪固酮回復正常。但病人不幸於手術後十個月過逝。因此種腎上腺皮質癌合併下腔靜脈與右心房腫瘤栓塞病例稀少，所以我們提出這個病例並回顧其他報告。

A 30-yr-old female was admitted for right upper abdominal pain and shortness of breath. Computed tomography and venacavography revealed a 20 x 16 x 12 cm mass occupying the right upper retroperitoneum with tumor thrombus extending into the inferior vena cava and right atrium. Assisted by cardiopulmonary bypass, an extended surgical resection including adrena-lectomy and resection of a portion of the inferior vena cava was performed. The defect in the inferior vena cava was successfully repaired with a piece of vein graft. The histology of the tumor showed adrenal cortical carcinoma with tumor thrombus extending via the adrenal vein and inferior vena cava into the right atrium. The post-operative course was uneventful; the patient gradually recovered, and dyspnea subsided after operation. Although the prognosis is grave for adrenal cortical carcinoma, this operation prevented sudden death in the young patient due to impending obstructive tumor thrombus in the right atrium. The patient expired due to multiple metastases over the liver and widespread retroperitoneal lymphadenopathy 10 mo. postoperatively.