Marshall, D.Gilbert, J.Byard, R.2008-04-142008-04-142007Forensic Science, Medicine, and Pathology, 2007; 3(1):53-561547-769X1556-2891http://hdl.handle.net/2440/41956A 26-year-old man who presented with a 2-year history of intermittent gynecomastia with recent onset of fever, night sweats, and abdominal distension was found to have a left-sided adrenocortical carcinoma with metastases to the liver and spine. Sudden death occurred 1 month after his presentation. At autopsy a saddle pulmonary thromboembolus was found occluding the pulmonary outflow tract, with smaller more peripheral pulmonary thromboemboli. No tumor deposits were identified in the thromboemboli. The thromboemboli had arisen from a tongue of tumor that had grown through the left adrenal vein into the inferior vena cava. Despite a high rate of angio-invasion there are very few reports of sudden death resulting from this phenomenon in patients with adrenocortical carcinoma.enJournal article002007412110.1385/FSMP:3:1:532-s2.0-3434734604046556Byard, R. [0000-0002-0524-5942]