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Case Report

Pak J Nucl Med. 2015; 5(1): 73-77

Radionuclide venography for the evaluation of collateral venous supply in inferior vena cava thrombosis before chemotherapy in a rare adrenal cortical carcinoma

Rashid Rasheed, Jawad A. Gillani, Abdul Samad, Khalid Hussain, Fayyaz Ahmad.


Adrenocortical gland carcinoma (ACC) is a rare tumour with an incidence of about one case per million population. Silent ACC are difficult to diagnose as they are asymptomatic until development of mass effects or other related symptoms. We present a case of a silent ACC in a female who was being planned for platinum-based chemotherapy. CT scan showed partial thrombosis of IVC confirmed by Doppler ultrasound. Radionuclide venography (RNV) was used to confirm inferior vena cava (IVC) flow. Blood flow in the IVC was seen to be reduced; however, there were well developed superficial collateral venous channels in the patient. This case shows that RNV is an effective tool for pre-chemotherapy assessment of venous blood flow, which may help in planning on the type of chemotherapy.

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