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Bilateral masses near kidneys: adrenal masses?

Sonopath Forum

Bilateral masses near kidneys: adrenal masses?

6 yo M/N Poodle mix, 27#, PUPD, drinks too much water and vomits. BSC4.5/9

Normal bloodwork. 

Region of the left adrenal gland: 4cm large, heterogeneous, hypoechoic mass with anechoic margins, growing around the aorta or other large vessel, pushing the intestines ventrally. Very vascular. Not attached to the left kidney. Normal L kidney. 

6 yo M/N Poodle mix, 27#, PUPD, drinks too much water and vomits. BSC4.5/9

Normal bloodwork. 

Region of the left adrenal gland: 4cm large, heterogeneous, hypoechoic mass with anechoic margins, growing around the aorta or other large vessel, pushing the intestines ventrally. Very vascular. Not attached to the left kidney. Normal L kidney. 

Region of the right adrenal: 2 large masses medial to right kidney. Cranial mass is heterogeneous, hypoechoic, 4cm, very vascular, similar to L mass. Caudal mass is almost 9 cm, heterogeneous, no blood flow, pushing the kidney laterally. Normal R kidney.

The rest of the abdomen is normal. 

Suspect bilateral adrenal ADK vs pheochromocytoma vs neoplastic aortic LN. What do you think?

Recommended metanephrine fractionation urine test and BP check + referral for CT. 

Thank you!

Julie

 

 

Comments

EL

Looks like a gigantic right

Looks like a gigantic right adrenal mass invading the cvc. The ao is next to it but i dont see the CVC which usually means its occupied by mass/thrombus. Using my imaginoscope a bit here but Im thinking “what does this pattern?” and right adrenal mass with extensive cvc invasion is my first thought.

sonopaws

Thanks Eric! I had just

Thanks Eric! I had just watched your adrenal lecture, so it was great timing… 

EL

Glad to be of help:)

Glad to be of help:)