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A 13-year-old SF Shepherd mix was presented for evaluation of episodic weakness, vomiting, and possible syncope. Abnormalities on serum biochemistry were elevated ALP activity (867) and creatinine (2.2).
A 13-year-old SF Shepherd mix was presented for evaluation of episodic weakness, vomiting, and possible syncope. Abnormalities on serum biochemistry were elevated ALP activity (867) and creatinine (2.2).
Invasive right adrenal gland mass. This is consistent with pheochromocytoma or adenocarcinoma. If no Cushingoid or endocrinopathy type clinical signs are noted then this is likely pheochromocytoma. Serial blood pressure measurements are recommended. Plavix therapy to reduce any potential clot attachment to the mass may provide some palliative treatment. However, the prognosis is guarded to poor. If hypertension is present, then antihypertensives would be warranted as that may be contributing to the clinical signs.
The left adrenal gland was uniform at 2.44 x 0.68 cm. The right adrenal gland comprised a mass that measured 3.4 cm. Heterogenous parenchymal changes were noted in the right adrenal gland with capsular escape and invasion into the vena cava through the phrenic vein. This extended for approximately 4.0 cm. This rendered it non resectable. Expansion of the vena cava is significant to approximately 2-3 times the size of the aorta. Regional inflammatory pattern was also noted. It was difficult to ascertain how much of the invasion is clot related versus thrombus. The patient is likely having issues with venous return stimulating a vagal response and appropriate vomiting.
None
Cardiac – pericardial effusion, cardiomyopathy, arrhythmia
Splenic neoplasia
Neoplasia – insulinoma, adrenal, liver
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