Case Study

Adrenal mass in an 11 year old FS Pit Bull Terrier

An 11-year-old FS Pitbull Terrier was presented for vomiting and anorexia. Physical examination found the patient quiet, alert, responsive, and PU/PD. Abnormalities on CBC and blood chemistry were monocytosis, elevated hemoglobin, mild hyperglycemia, and hypoglobulinemia. A possible abdominal mass was evident on lateral survey abdominal radiographs. The patient was admitted for I.V. fluids and further work-up.

Sonographic Differential Diagnosis

This is most consistent with adenocarcinoma, pheochromocytoma or pronounced nodular hyperplasia. Given the clinical signs, resection would be warranted. Blood pressure measurements are indicated. Given that PU/PD was present in the history, with urine specific gravity persistently less than 1.025, an adrenal gland panel (University of Tennessee) or a dynamic function test (ACTH stim/LDDST) could be submitted in order to assess the functionality of the adrenal mass. Three view chest radiographs, left adrenalectomy, and gastric biopsies would all be indicated based on this ultrasound study.

Image Interpretation

The stomach was thickened in this patient with edematous contour. This continued up into the esophageal inlet. This is likely gastritis; however, early infiltrative disease cannot be entirely ruled out. The right adrenal gland appeared normal in size and contour. However, the left adrenal gland was entirely composed of a microcystic thickened nodular mass that measured 4.2 x 2.15 cm with 4.3 cm circumference. No adrenal CVC invasion was noted.