Table 1. Intra-operatory approach (venous control) for adrenocortical mass with tumour/thrombus extending into the IVC/RA.

Extension of the adrenocortical mass	Surgical approach
Tumour/thrombus below the hepatic vein, level I	Cross clamping of IVC
Infra-diaphragmatic tumour/thrombus (retro or supra-hepatic), level II–IIIa	HVE
Supra-diaphragmatic tumour/thrombus (IVC/RA), level IIIb–IV	Cardiopulmonary bypass ± hypothermic circulatory arrest

IVC, inferior vena cava; RA, right atrium; HVE, hepatic vascular exclusion.