Sammy is a 12 yr old mn Lhasa/bichon cross. Lately he has been pd/pu and urinating in the house at night. HIs lab work was normal (no alk phos or ggt elevation) His u/a showed a sg of 1.020. He was treated with a course of cipro but it made no difference in his signs. His left adrenal was enlarged but symmetric, caudal pole 7.6 mm. So is he cushingoid, hypercoagulable and has a venous thrombosis or does he ahve an invasive right adrenal tumor?
Sammy is a 12 yr old mn Lhasa/bichon cross. Lately he has been pd/pu and urinating in the house at night. HIs lab work was normal (no alk phos or ggt elevation) His u/a showed a sg of 1.020. He was treated with a course of cipro but it made no difference in his signs. His left adrenal was enlarged but symmetric, caudal pole 7.6 mm. So is he cushingoid, hypercoagulable and has a venous thrombosis or does he ahve an invasive right adrenal tumor?
Comments
nice image set and maneuver.
nice image set and maneuver. Tumors and throbi can look the same. Put power Doppler over it and see if its vascularized. This may only be a thrombus since the rest of the right adrenal doesn’t look bad. I have partially dissolved these with aspirin a while ago and plavix over the last few years. Plavix trial and see what happens .. out of the box but … why not? Interventional vascular surgeon is the other option. Chick Weisse in NYC may be playing around with these. I can ask him.
nice image set and maneuver.
nice image set and maneuver. Tumors and throbi can look the same. Put power Doppler over it and see if its vascularized. This may only be a thrombus since the rest of the right adrenal doesn’t look bad. I have partially dissolved these with aspirin a while ago and plavix over the last few years. Plavix trial and see what happens .. out of the box but … why not? Interventional vascular surgeon is the other option. Chick Weisse in NYC may be playing around with these. I can ask him.
As to my conversation with
As to my conversation with Chick Weisse at AMC regarding invasive tumors and thrombi. He at AMC in NYC does this:
EL: Invasive adrenal tumors and tcvc thrombi, are you doign anything wiht these IR?
CW: If they have ascites yes. Otherwise surgery…
EL: So essentially if the mass is invaded to the level of the hepatic vein inflow into the cvc you do IR otherwise traditional approach sx into the cvc?
CW: Correct!
Hope this helps Jeff
As to my conversation with
As to my conversation with Chick Weisse at AMC regarding invasive tumors and thrombi. He at AMC in NYC does this:
EL: Invasive adrenal tumors and tcvc thrombi, are you doign anything wiht these IR?
CW: If they have ascites yes. Otherwise surgery…
EL: So essentially if the mass is invaded to the level of the hepatic vein inflow into the cvc you do IR otherwise traditional approach sx into the cvc?
CW: Correct!
Hope this helps Jeff
Just curious, what would the
Just curious, what would the interventional radiological procedure involve?
Just curious, what would the
Just curious, what would the interventional radiological procedure involve?
Floroscopy guided retrieval
Floroscopy guided retrieval through vascular access.
Floroscopy guided retrieval
Floroscopy guided retrieval through vascular access.