Case Study

Adrenal Mass with Left Phrenic Invasion in a 10 year old FS Yorkie mix

This 10 year old FS Yorkie mix presented with a history of lethargy; while still eating, urinating and deficating normally. She then began shaking, the abdomen became distended and she stopped eating or drinking.

UA- isothenuria and proteinuria. 3 small bladder stones were collected when obtaining UA and 4dx negative. SDMA 16, BUN 37, CREAT 1.6, Phos 7.3, CA 12, NA/K 27, ALB 2.6, ALT 531, ALKP 4087, GGT 82, AMY 1882 and LIP 3501.

DX

Invasive left adrenal tumor

Sonographic Differential Diagnosis

carcinoma vs. pheochromocytoma

Image Interpretation

The left adrenal gland revealed a mixed hypoechoic expansive mass measuring 2.54 cm x 1.57 cm with phrenic vein and caval invasion.

Outcome

The left adrenal gland appeared to be resectable with carcinoma vs. pheochromocytoma as the primary differentials. No obvious evidence of metastatic disease was noted.
Urine catecholamine testing along with serial blood pressures, surgical consultation and 3-view thoracic radiographs were recommended.