Key result
Urgent surgical excision of metastatic left atrial adrenocortical carcinoma yields no recurrence at 6 months.
Why the study?
Cardiac metastases from adrenocortical carcinoma are exceptionally uncommon, especially as isolated left-sided involvement rather than right atrial extension via the inferior vena cava. Such intracardiac metastases can mimic primary cardiac tumors like atrial myxomas, creating diagnostic challenges and increasing the risk of systemic embolization.
Case Report (n=1)
No
This case demonstrates that adrenocortical carcinoma can rarely metastasize to the left atrium and pulmonary veins, mimicking a primary cardiac myxoma and causing cardioembolic stroke, where early surgical excision and pulmonary vein clearance can prevent recurrent embolization.
Answers are grounded in this paper and cite their sources.
May support urgent excision for rare intracardiac adrenocortical metastases; leaves open broader management guidance pending larger studies.
Background: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a strong tendency for early metastatic dissemination. Cardiac metastases are exceptionally uncommon and usually occur through tumor extension via the inferior vena cava into the right atrium, rather than as isolated left-sided involvement. Intracardiac metastases may mimic primary cardiac tumors such as atrial myxomas, creating diagnostic challenges and increasing the risk of systemic embolization. Case presentation: A patient with a history of ACC presented with transient neurological deficits consistent with cardioembolic stroke. Brain magnetic resonance imaging demonstrated multiple acute embolic infarcts. Transthoracic and transesophageal echocardiography revealed two distinct left atrial masses, one attached to the interatrial septum and another highly mobile lesion extending toward the left superior pulmonary vein. Management and outcome: Urgent surgical intervention was performed due to the high embolic risk. Both lesions were completely excised, and histopathological examination confirmed metastatic ACC. Conclusion: Cardiac metastases should be considered in patients with ACC who present with embolic events and left atrial masses.
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TOPUZ et al. (2026) conducted a case report in Metastatic adrenocortical carcinoma with left atrial mass, left superior pulmonary vein involvement, and cardioembolic stroke (n=1). Surgical excision of left atrial masses and Fogarty catheter clearance of the left superior pulmonary vein was evaluated on Recurrent neurologic events and intracardiac mass recurrence at 6-month follow-up. Urgent surgical excision of metastatic adrenocortical carcinoma from the left atrium and pulmonary vein resulted in 0 recurrent embolic events or intracardiac recurrence at 6-month follow-up.
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