tetralogy of fallot associated with invasive adrenocortical tumor in an adult woman

migration of cardiac neural crest cells into the pharyngeal arches and the pharyngeal and splanchnic mesoderm contributes to the development of the cardiac outflow tract. the adrenal cortex is derived from the splanchnic mesoderm. neuroblastoma is more prevalent in patients with congenital heart disease than in the general population, because both originate from embryonal neural crest-derived cells. similarly, and in light of recent embryological findings, abnormal development or migration of splanchnic mesoderm, possibly due to an underlying genetic defect, could contribute to the association of adrenocortical carcinoma and tetralogy of fallot. we present the case of a cardiologically asymptomatic 49-year-old woman with total correction of tetralogy of fallot in the first year of life.