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Suspect Left Adrenal Carcinoma in 14 year old MN DSH

Case Study

Suspect Left Adrenal Carcinoma in 14 year old MN DSH

A 14-year-old NM DSH was presented for evaluation of no hair regrowth, weight gain, and increased appetite. Urine SG was 1.018, blood pressure 160/85, and CBC and serum biochemistry within reference range.

A 14-year-old NM DSH was presented for evaluation of no hair regrowth, weight gain, and increased appetite. Urine SG was 1.018, blood pressure 160/85, and CBC and serum biochemistry within reference range.

Sonographic Differential Diagnosis

: Enlarged, irregular left adrenal gland. Suspect left adrenal carcinoma. Age related renal changes

Image Interpretation

The left adrenal gland was enlarged and irregular measuring 1.5 cm with loss of corticomedullary definition. Focal areas of mineralization were noted within the left adrenal gland. Mild, excessive vascularity was noted on the left adrenal gland. This is strongly suggestive for carcinoma. This appears to be impinging upon the vena cava, yet no actual invasion was noted.

The kidneys revealed largely normal size and structure, corticomedullary definition and ratio (cortex 1/3 of medulla) were essentially maintained with some age related loss of curvilinear patterns. The cortices presented largely uniform texture with some age related echogenic changes that are not likely of clinical significance at this time unless inflammatory sediment or proteinuria is present. Medullary echogenicity differed distinctly from that of the cortex and no evidence or dilation could be seen. The capsules were acceptably uniform for this age patient without dramatic irregularities. Slight mineralization was noted in the kidneys. The left and right kidney measured 4.5 cm.

DX

Suspected Adrenal Carcinoma

Outcome

LDDST is recommended with induction at 0.1 mg/kg or direct left adrenalectomy would be recommended. Blood pressure measurements would also be warranted. Sodium potassium ratio would be recommended. If hypokalemia is present then aldosterone level would be warranted to assess for Conn’s syndrome.

Clinical Differential Diagnosis

Functional adrenal neoplasia
Primary skin – allergic dermatitis, parasites, psychological/behavioural

UA Specific Gravity Range

1.018

Patient Information

Patient Name : KC Farquar
Gender : Male, Neutered
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Code : 07_00194

Clinical Signs

  • Hair loss
  • Polyphagia
  • Weight gain

Images

b1b2

Clinical Signs

  • Hair loss
  • Polyphagia
  • Weight gain