Case Study

Adrenal mass with caudal vena caval invasion in an 11 year old FS Schnauzer mix

An 11-year female spayed Schnauzer mix dog was presented for evaluation of weight loss, poor appetite, pyrexia, and recently diagnosed diabetes mellitus. Physical examination was normal. Abnormalities on serum biochemistry were elevated liver enzyme activity (ALP > 2400, ALT 1576), bilirubin, and hyperglycemia (355).

Sonographic Differential Diagnosis

Right adrenal mass invading the caudal vena cava. Differentials include: cortical neoplasia (adrenal adenocarcinoma, Cushing’s disease), non-functional adenoma, myelolipoma, hyperplasia, medullary neoplasia (pheochromocytoma), and functional adenoma.

Image Interpretation

The left adrenal gland was normal in size, shape and echogenicity measuring 5.9mm. The right adrenal gland revealed a large round cranial pole measuring 15.4mm, with complex heterogeneous echogenicity and punctate mineralizations within the parenchyma. There is evidence of invasion into the caudal vena cava (CVC).

DX

Adrenal mass with invasion into the CVC

Outcome

None

Comments

Case courtesy of Marty Henderson, DVM. SonoVet, Inc.

Clinical Differential Diagnosis

Uncontrolled diabetes mellitus. Hepatic disease: acute hepatitis (viral, bacterial, toxins), neoplasia, abscess, granulomatous disease; Gall bladder disease: cholecystitis, mucocele, neoplasia; Pancreatic disease: pancreatitis, neoplasia.