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Adrenal mass in a 12 year old MN Pug

Case Study

Adrenal mass in a 12 year old MN Pug

The patient is a neutered male 12 year old Pug, who was presented to ER for collapsed trachea, lethargy, and inappropriate urination. Blood work and urinalysis revealed anemia, increased WBCs, and a UTI. The dog went home on Amoxicillin; recheck CBC still showed anemia. Urine specific gravity 1.025, trace blood, pH 7.5

 

DX

Right adrenal mass

Sonographic Differential Diagnosis

Large, extensive right adrenal gland mass that enveloped the vena cava and right ureter. Pheochromocytoma is the primary differential. Adenocarcinoma is also possible, yet less likely. Slight, secondary right hydronephrosis. Splenic masses are suggestive of metastatic disease.
Nodular hepatic changes may be due to independent nodular hyperplasia or micrometastatic lesions from the right adrenal gland.

Image Interpretation

The scan of the right adrenal gland demonstrated a very complex cystic and nodular mass that measured 6 x 5.7 cm. This displaced and appeared to be attached to the right kidney. The mass obstructed the right ureter and enveloped the vena cava. The left adrenal gland was uniform at 2.1 x 0.58 cm. Slight nodular change was noted cranial to the left adrenal gland or regional lymph node and measured approximately 0.8 cm.
The right kidney was displaced and revealed pyelectasia that measured 0.55 cm. The right kidney itself measured 5.26 cm. The left kidney was unremarkable at 4.64 cm with slight, age related changes.
Nodular hepatic changes and splenic masses were also noted.

Outcome

None

Clinical Differential Diagnosis

UTI, urolithiasis, neoplasia, coagulopathy, bone marrow disease, blood loss.

UA PH

7.5

UA PH

7.5

Sampling

FNA of the right adrenal gland mass, splenic mass and liver would be recommended for further definition to assess for metastatic disease.

UA Specific Gravity Range

1.025

Patient Information

Patient Name : Bandit G
Gender : Male, Neutered
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 07_00136

Images

golabiewski_bandit_right_adrenal_mass_golabiewski_bandit_right_adrenal_mass_2golabiewski_bandit_right_adrenal_mass_left_adrenalgolabiewski_bandit_right_adrenal_mass_rkgolabiewski_bandit_right_adrenal_mass_liver

CBC

  • RBC, Low
  • WBC, High

Urinalysi

  • Bacteria Present