Background: With an annual incidence of 0.2% of new cases per 100,000 inhabitants, adrenocortical carcinoma is rare. In advanced tumor only palliative treatment modalities are practicable. Because of scarcity of the tumor, standard treatment has not been defined. The decision on therapy frequently depends on the individual situation. Tumor embolization and chemotherapy are amongst the possible options. Patient and Methods: We report on a case of a 32-year-old female patient with a large-volume hormonally active adrenocortical carcinoma and hematogenous liver metastases. This carcinoma was confirmed histologically by means of liver biopsy. Owing to the large tumor extent and metastatic spreading and also in view of the poor general condition of the patient, curative surgical therapy was not possible. For this reason, a local approach was chosen primarily with transarterial tumor embolization at the capillary level. Systemic chemotherapy was given afterwards. Results: Improvement of the patient's general condition, especially the pronounced pain symptoms, could be achieved for a short time by the embolization: both, the patient's clinical condition and the laboratory test parameters improved. However, a rapid tumor progression occured under chemotherapy, which was started after embolization. Conclusion: In advanced adrenocortical carcinoma, tumor embolization can lead to a stabilization of the disease and improvement of the symptoms as appraised by palliative criteria in some patients.