5 year old Husky
Post-dental, became acutely PU/PD. Tested positive for atypical Cushing’s with increased estradiol. Started treatment with melatonin, lignans, etc. Chemistries and CBC were normal. Urine culture and sensitivity negative, USG 1.015.
Presented Saturday for limping. Has always had a funny gait but was favoring right front limb. Right ulnar radiographs revealed bone lesion mid-diaphysis with destruction of the cortical bone. (sorry, radiographs are not available)
5 year old Husky
Post-dental, became acutely PU/PD. Tested positive for atypical Cushing’s with increased estradiol. Started treatment with melatonin, lignans, etc. Chemistries and CBC were normal. Urine culture and sensitivity negative, USG 1.015.
Presented Saturday for limping. Has always had a funny gait but was favoring right front limb. Right ulnar radiographs revealed bone lesion mid-diaphysis with destruction of the cortical bone. (sorry, radiographs are not available)
Chest radiographs were unremarkable, no metastasis.
Abdominal ultrasound: right adrenal mass with caudal vena cava invasion pressing on the renal artery seen with a homogenously hypoechoic mass seen caudally associated with hyperechoic mesenteric fat. Aspirated hypoechoic mass and only RBC’s seen on cytology.
Is the mass caudal to the adrenal mass a hematoma secondary to vasculare invasion AND is the bone lesion associated with the adrenal mass? (systemic blood pressure is unavailable) Pheochromocytoma?
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Found this on
Found this on VIN
Article Abstract
This report presents the clinical, laboratory, imaging, and pathologic findings in 61 dogs with pheochromocytoma by retrospective evaluation of medical records. Pheochromocytomas were diagnosed by histopathologic examination of tissue specimens in all dogs. Special stains (chromogranin A and synaptophysin) also were used to confirm the chromaffin cell origin of the tumors. Epidemiologic findings were in agreement with previous studies, indicating that pheochromocytomas affect middle-aged to older dogs with no apparent gender or breed predilection. The tumor was considered clinical in 21 dogs (34%), was responsible for abnormalities related to a space-occupying mass in 7 dogs (11%), and was an incidental finding in 35 dogs (57%). The hematologic and biochemical findings were nonspecific. Hypertension was detected in 10 of 23 (43%) dogs tested, but all hypertensive dogs had concurrent diseases that may have contributed to hypertension. Abdominal ultrasonography was the most commonly used imaging procedure, with a mass detected in the region of the adrenal glands in 20 of 40 (50%) dogs examined. In 4 of the 20 dogs (20%), invasion of the caudal vena cava was identified. Surgery was performed in 17 dogs (28%) with immediate death or euthanasia of 5 dogs. Survival after surgery ranged from 1 day to 3.25 years. Pheochromocytomas were locally invasive in 39% of affected dogs and produced metastases in 13% of the cases. Common sites for metastases included regional lymph nodes, liver, lung, kidney, spleen, and bone. A high frequency of concurrent neoplasia (54%), including endocrine neoplasia, was identified.
Found this on
Found this on VIN
Article Abstract
This report presents the clinical, laboratory, imaging, and pathologic findings in 61 dogs with pheochromocytoma by retrospective evaluation of medical records. Pheochromocytomas were diagnosed by histopathologic examination of tissue specimens in all dogs. Special stains (chromogranin A and synaptophysin) also were used to confirm the chromaffin cell origin of the tumors. Epidemiologic findings were in agreement with previous studies, indicating that pheochromocytomas affect middle-aged to older dogs with no apparent gender or breed predilection. The tumor was considered clinical in 21 dogs (34%), was responsible for abnormalities related to a space-occupying mass in 7 dogs (11%), and was an incidental finding in 35 dogs (57%). The hematologic and biochemical findings were nonspecific. Hypertension was detected in 10 of 23 (43%) dogs tested, but all hypertensive dogs had concurrent diseases that may have contributed to hypertension. Abdominal ultrasonography was the most commonly used imaging procedure, with a mass detected in the region of the adrenal glands in 20 of 40 (50%) dogs examined. In 4 of the 20 dogs (20%), invasion of the caudal vena cava was identified. Surgery was performed in 17 dogs (28%) with immediate death or euthanasia of 5 dogs. Survival after surgery ranged from 1 day to 3.25 years. Pheochromocytomas were locally invasive in 39% of affected dogs and produced metastases in 13% of the cases. Common sites for metastases included regional lymph nodes, liver, lung, kidney, spleen, and bone. A high frequency of concurrent neoplasia (54%), including endocrine neoplasia, was identified.
Forgot to note that the left
Forgot to note that the left adrenal gland was normal (6.6mm)
Forgot to note that the left
Forgot to note that the left adrenal gland was normal (6.6mm)
Images are a bit dark but
Images are a bit dark but piecing it together it fits. Diffs for invading adrenal masses are pheo and carcinoma and they will have a variety of production and pressures that go wiht them. ASt first I thought this was a hot LN but given the position it looks invasive pheo. CT and sx consult finding tyhr right surgeon I have seen up to 3 cm invasion surgically removed but those surgeons are few and far between and really like a challenge.
Lots more “pheochromocytoma” cases on the search engine on sonopath
http://sonopath.com/members/case-studies/search?text=pheochromocytoma&species=All
Nice post… fyi the logic e tends to drop the gain about 10 points when exporting jpeg avi so its best to increase the gain on appropriate clips and offload. Glitch in the sw. When exporting dicom you can adjust in osirix or other dicom viewer easily enough if necessary
Images are a bit dark but
Images are a bit dark but piecing it together it fits. Diffs for invading adrenal masses are pheo and carcinoma and they will have a variety of production and pressures that go wiht them. ASt first I thought this was a hot LN but given the position it looks invasive pheo. CT and sx consult finding tyhr right surgeon I have seen up to 3 cm invasion surgically removed but those surgeons are few and far between and really like a challenge.
Lots more “pheochromocytoma” cases on the search engine on sonopath
http://sonopath.com/members/case-studies/search?text=pheochromocytoma&species=All
Nice post… fyi the logic e tends to drop the gain about 10 points when exporting jpeg avi so its best to increase the gain on appropriate clips and offload. Glitch in the sw. When exporting dicom you can adjust in osirix or other dicom viewer easily enough if necessary
Thanks Eric! What are your
Thanks Eric! What are your thoughts about the ulnar bone lesion? Unrelated? Metastasis? Or hard to say?
Thanks Eric! What are your
Thanks Eric! What are your thoughts about the ulnar bone lesion? Unrelated? Metastasis? Or hard to say?
Did you scan it? Have a rad?
Did you scan it? Have a rad? If the periosteum is compromized you can scan it and do an USG 16 g fna with a local and stick the variety of hypoechoic areas wihtin the lytic lesion. Hypertrophic osteopathy??? separate lesion??? When I have a ? I put a needle in it:)
Did you scan it? Have a rad?
Did you scan it? Have a rad? If the periosteum is compromized you can scan it and do an USG 16 g fna with a local and stick the variety of hypoechoic areas wihtin the lytic lesion. Hypertrophic osteopathy??? separate lesion??? When I have a ? I put a needle in it:)
Never thought to scan it. 🙂
Never thought to scan it. 🙂 will remember to next time. When in doubt, stick it! 🙂
Never thought to scan it. 🙂
Never thought to scan it. 🙂 will remember to next time. When in doubt, stick it! 🙂
Yes and have a solid
Yes and have a solid relationship with a cytologist to read it:)
Yes and have a solid
Yes and have a solid relationship with a cytologist to read it:)