Adrenal masses with possible mets

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Adrenal masses with possible mets

  • 11 year old collie x FN dog, presented for possible abdominal pain
  • Bilateral adrenal masses, left 2cm distorting shape but does not appear to be invading vasculature
  • Also seeing what I think are local lymph nodes? – hypoechoic striated structures by ven, adrenal glands and pylorus
  • Subtle irregular contoured hypoechoic liver lesions – do these look like mets?
  • Normal LDDST with concentrated urine, the dog is not clinically cushingoid
  • What would you recommend from here? 

  • 11 year old collie x FN dog, presented for possible abdominal pain
  • Bilateral adrenal masses, left 2cm distorting shape but does not appear to be invading vasculature
  • Also seeing what I think are local lymph nodes? – hypoechoic striated structures by ven, adrenal glands and pylorus
  • Subtle irregular contoured hypoechoic liver lesions – do these look like mets?
  • Normal LDDST with concentrated urine, the dog is not clinically cushingoid
  • What would you recommend from here? 

Comments

EL
November 5, 2018 at 4:11 pm -

Looks like adenoma or even

Looks like adenoma or even pheo on the right. Run a urine catecholamine and serial BP to assess any funcitonality there and followup in a month for any growth or change in contour. Some hetero pancreas and minor reactive looking hepatic LN in the last view of the pylorus. The liver nodules dont disrupt architecture so likely nodular hyperplasia but fna to be sure. When nodules like this are clinical usually the patient is clinically “ADR” and you see a liver enzume drive going up rapidly.

veteurope1
November 5, 2018 at 6:27 pm -

Sorry I did not attach the

Sorry I did not attach the image of the left adrenal.

Is it a lymph node in the second half of video 1 by right adrenal/vena cava or is that a cystic structure within the end of pancreas?

There was a similar structure cranial to the left adrenal gland but now that I review it, it could be adjacent to the left limb of the pancreas

Thanks for your help EL. Trying to decide whether to send dog for a left sided adrenalectomy…

EL
November 6, 2018 at 11:14 pm -

your first image looks like

your first image looks like an adrenal adenoma, the second is either a cystic LN or pancreatic cyst.

veteurope1
November 7, 2018 at 9:21 pm -

Thanks EL, I will sample this

Thanks EL, I will sample this dog and report back. 

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