Case Study

Invasive right adrenal tumor in a 13 year old MN Jack Russell Terrier

A 13-year-old MN Jack Russell Terrier dog presented for a second opinion with panting, weakness, and anorexia. The physical exam revealed mild gingival pallor and mild tachypnea. Complete blood count revealed strongly regenerative anemia (HCT 22%) with spherocytes, marked polychromasia, anisocytosis, and moderate neutrophilic leukocytosis. Blood chemistry revealed only slight azotemia. In house 4Dx was negative. Blood pressure was 159/98. Urinalysis was pending at the time of the sonogram but urination was reported to be normal.

Sonographic Differential Diagnosis

Invasive right adrenal gland tumor. Differentials include pheochromocytoma or adenocarcinoma considering the invasive nature of the presentation. If clinical hyperadrenocorticism is present then adenocarcinoma is likely.

Image Interpretation

A roughly 2.5 cm right mass is seen invading the right adrenal gland. There is loss of parenchymal detail and corticomedullary junction distinction. The tumor invades approximately 2 cm into the lumen of the vena cava. The invasive process could represent either tumor and/or attached thrombus.

DX

Invasive right adrenal tumor

Outcome

The patient was lost to follow-up.

Clinical Differential Diagnosis

Hemolytic anemia, blood loss, underlying neoplasia, infection (ex: pyelonephritis, pneumonia), undetected infectious disease, tick borne (despite negative 4dx), Cushing`s, pulmonary thromboembolism.