Adrenal carcinoma is a rare tumor and with metastasis usually in lungs, lymph nodes, liver, and bones. However, intracaval invasion extending into the right atrium is very rare. The surgical approach to adrenal tumor extending into the vena cava is challenging. The optimal surgical approach of tumor with inferior vena cava extension depends on the level of vena cava involvement. This article reports a case of malign pheochromocytoma extending into the cavoatrial junction in a young man.