Case Study

Adrenal carcinoma diagnosed by ultrasound-guided FNA in a 10 year old FS Golden Retriever

10 year old FS Golden Retriever dog was presented for dysuria. The dog also had a history of hypothyroidism. The urinalysis revealed a low specific gravity, hematuria and increased WBCs. The dog returned two days later for the evaluation of excessive panting and constant discomfort and distress. The physical exam was unremarkable except for pustules on the ventral abdomen and dorsum. Blood chemistry showed hyperphosphatemia and an elevated GGT enzyme activity. The ACTH stimulation test results were within normal limits.

DX

Adrenal carcinoma

Sonographic Differential Diagnosis

Invasive left adrenal mass: adrenal carcinoma or pheochromoctyoma possible.

Image Interpretation

A mixed hypoechoic left adrenal mass is present with extensive invasion into the caudal vena cava. It is not possible to differentiate tumor invasion from attached thrombus.

Outcome

Owner elected to humanely euthanize due to the patient’s gradual decline in health.

Clinical Differential Diagnosis

Hyperadrenocorticism (pituitary or adrenal gland dependent) with secondary hypertension. If adrenal gland dependent, a carcinoma is the most likely diagnosis based on the acute deterioration of the dog. Pheochromocytoma and other forms of neoplasia that could affect nociception and pain receptors (ex. stretching of a capsule of an organ) are also possible.