Case Study

Adrenal adenocarcinoma in a 5 year old MN ferret

The patient is a 5 year old neutered male ferret. Pet was presented because he was lethargic, dragging hind legs at times, had abnormal stools, and may have been inappetent. Physical exam revealed a large mass in region of left kidney. Pet did have spleen removed two years prior to today’s visit which came back as benign splenic congestion with no evidence of neoplasia. A lymph node also biopsied from that area that came back as reactive lymphocytic hyperplasia. Recent radiographs revealed a radiopaque region in cranial abdomen, adjacent to left kidney.

Sonographic Differential Diagnosis

Left adrenal gland mass with mineralization and likely vascular invasion. Left kidney displacement.
This is likely adenocarcinoma.

Image Interpretation

A hypoechoic mass was noted in the region of the left adrenal gland which was adhered to the left kidney with displacement. Focal free fluid accumulation as well as reactive surrounding fat were seen in this region. This is likely a left adrenal gland tumor. Regional peritonitis was present. The region of the right adrenal gland appeared largely normal. However, a focal area of 1.0 cm of mineralization was noted. It could not be assessed if this was deriving from the right adrenal gland or left adrenal gland mass. This is most likely deriving from a portion of left adrenal gland mass, suggestive of dystrophic mineralization from adenocarcinoma.

DX

Adrenal adenocarcinoma

Outcome

The patient died during exploratory surgery.

Clinical Differential Diagnosis

Adrenal mass, renal mass, other neoplasia, polycystic kidney, lymphoma (including spinal lymphoma)
check for hypoglycemia (many hypoglycemic ferrets drag their legs)