Tehran University of Medical Sciences Basic & Clinical Cancer Research 2228-6527 9 1 2017 03 01 40 45 EN Mazaher Ramezani Molecular Pathology Research Center, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Farhad Kavousi Molecular Pathology Research Center, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Farhad Amirian Molecular Pathology Research Center, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Masoud Sadeghi Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran 2016 12 18 2017 01 28 Adrenocortical carcinomas (ACC) is an uncommon disease that accounts for only 0.02% of all cancers. Herein, this study evaluates a case of adult ACC with extension into the inferior vena cava and Cushingoid features. A 67-year-old lady was admitted to the surgery service for surgical resection of adrenal mass which was found on hypertension work-up. On physical examination, she was fat, cushingoid and had ecchymoses on her skin. The patient was hypokalemic at the time of admission. Spiral CT with contrast of the abdomen and pelvis was done and showed solid mass measuring 10x11 cm, upper to the right kidney and posterior to IVC (inferior vena cava) with anterior displacement of IVC. Microscopic diagnosis was adrenocortical carcinoma with vascular invasion and necrosis (20% of surface area) in this case. In conclusion, the hypertension can be the most common complaints in ACC patients and probably, the existence of both hypertension and hypokalemia in a case can increase suspicion of ACC that it needs to future studies with focus on these complaints. https://bccr.tums.ac.ir/index.php/bccrj/article/view/228 https://bccr.tums.ac.ir/index.php/bccrj/article/download/228/02