We present a case of a 64-year-old woman who underwent multivisceral resection for the treatment of metastasis adrenal tumor. Preoperative images showed a retroperitoneal lesion invading the retrohepatic cava 2 cm from the confluence of the suprahepatic veins, with involvement of the caudate lobe, right kidney, and transverse colon. A multivisceral resection was performed with an operative time of 360 minutes, intraoperative bleeding of 1200cc, requiring intraoperative transfusion of 3 units of red blood cells. The retrohepatic vena cava was replaced, just below the arrival of the suprahepatic veins to the level of the renal veins (preserving the left). We use a synthetic dacron prosthesis with a clamp time of 29 minutes. The patient was in the ICU for 4 days and was discharged from the hospital on day 12 postoperatively. She initially presented with renal dysfunction that did not require dialysis therapy. The patient is currently completing 6 months of follow-up with no evidence of relapse.