This 12 year old MN Pomeranian has a history of hepatocutaneous syndrome, PDH (on trilostane), and hypothyroidism (on levothyroxine). Also on carprofen. Recently presented for gradual loss of energy and variable appetite.
This 12 year old MN Pomeranian has a history of hepatocutaneous syndrome, PDH (on trilostane), and hypothyroidism (on levothyroxine). Also on carprofen. Recently presented for gradual loss of energy and variable appetite.
The left adrenal gland was subnormal in size and measured 1.66 x 0.46 cm at the caudal pole and 0.36 cm at the cranial pole. The right adrenal gland comprised a mass that measured 2.63 x 2.0 cm at the cranial pole and 1.08 cm at the caudal pole. This is strongly consistent with adenocarcinoma, possible adenoma or pheochromocytoma. The liver in this patient was diffusely nodular with coarse architecture. Coalescing nodular changes and increased portal markings were noted. This is strongly consistent with hepatocutaneous syndrome given the dermal biopsies. Hepatic FNA or biopsywould be ideal for confirmation; however, subjectively the changes are consistent with hepatocutaneous syndrome. Variable atrophy and hypertrophy of the liver was noted. This is consistent with reorganization owing to chronic disease. Cirrhosis is also a potential in this case, yet less likely.
Subnormal left adrenal gland size. Mild to moderate chronic interstitial nephrosis renal pattern. FNA or core biopsy of the liver is recommended. Serial blood pressure measurements
would be warranted. Another option would include right adrenalectomy and liver
biopsy. However, given the probable diagnosis of hepatocutaneous syndrome the long
term viability is guarded.
