Exceptionally rare, highly aggressive and difficult to identify, adrenocortical carcinoma (ACC) affects about one person in a million. Surgical resection of the adrenal is a frequent and effective treatment. Venous thromboembolism (VTE) is a serious, potentially fatal condition which can occur postoperatively. However, its frequency in patients with ACC is unclear.

Durmuşoğlu et al. conducted a retrospective study at Radboud University (Nijmegen, The Netherlands) using patient data registered between 2003 and 2018. The cohort included a range of ACC types, including non-functional tumours, overt hypercortisolism, cortisol- and androgen-producing and subclinical hyper-cortisolism. Data from 34 patients revealed that 8 experienced VTE within 6 months of surgery; all of these were pulmonary embolisms, with no overt signs of deep vein thrombosis of the leg.

This work shows that VTE occurs in 23.5% of postoperative ACC patients, demonstrating a high incidence. Previously, it had been projected to have a low risk of approximately 2–3%. The study highlights the need to consider postoperative VTE in this patient group, and calls for more work to better inform clinicians regarding the optimal duration of thromboprophylaxis for ACC patients.

Read the full article in Endocrine Connections 9 874–881