Case Study

Adrenal mass in a 12 year old FS Shih Tzu with hypertension

A 12-year-old SF Shih Tzu dog was presented for evaluation of hypertension that was controlled with 0.625mg amlodipine three times daily. CBC showed mild leukopenia, whereas serum biochemistry was within normal limits.

A 12-year-old SF Shih Tzu dog was presented for evaluation of hypertension that was controlled with 0.625mg amlodipine three times daily. CBC showed mild leukopenia, whereas serum biochemistry was within normal limits.

DX

Adrenal mass

Sonographic Differential Diagnosis

Right adrenal gland mass. The right adrenal gland mass appears resectable. However, CT verification would be recommended. The vena cava in the region of the right adrenal gland mass appeared free of evident invasion or thrombi. Primary differentials include pheochromocytoma, adenocarcinoma (which may or may not be functional), myelolipoma or regenerative nodule. Given the hypertension, pheochromocytoma is strongly suspected. Surgical intervention with right adrenalectomy and splenectomy would be warranted. If urine specific gravity is less than 1.020, functional adenocarcinoma is possible.

Image Interpretation

The left adrenal gland was uniform with slight, heterogenous parenchyma. No left adrenal gland pathology was noted. The right adrenal gland was comprised of an echogenic mass deriving from the cranial pole and measuring 3.0 cm. There was no evidence of caval invasion. CT evaluation would be warranted to assess potential caval invasion prior to surgical resection. This would explain the hypertension in this patient. The vascularity was mild to moderate.