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Left adrenal mass with CVC invasion in a 12 year old MN Shih Tzu

Case Study

Left adrenal mass with CVC invasion in a 12 year old MN Shih Tzu

A 12-year-old NM Shih Tzu dog with a history of congestive heart failure was presented for evaluation. Serum biochemistry revealed a severely elevated ALP.

A 12-year-old NM Shih Tzu dog with a history of congestive heart failure was presented for evaluation. Serum biochemistry revealed a severely elevated ALP.

Sonographic Differential Diagnosis

Left adrenal gland mass wrapping around the aorta and invading the vena cava. This is strongly suggestive of pheochromocytoma or carcinoma. Blood pressure measurements are recommended as well as palliative therapy. Unfortunately, this mass does not appear resectable.

Image Interpretation

A highly vascular, hypoechoic left adrenal gland mass can be seen invading the vena cava. The invasion extends into the vena cava by approximately 2-3 cm. The mass has an irregular contour. There are areas of mineralization within the mass. The mass appears to wrap around the aorta as well.

DX

Left adrenal gland mass wrapping around the aorta and invading the vena cava.

Outcome

None

Clinical Differential Diagnosis

Adrenal disease (hyperadrenocortism, neoplasia such as adenoma, adenocarcinoma, or pheochromocytoma), primary liver/gall bladder disease (neoplasia, cholecystitis, bile duct obstruction, mucocele).

Sampling

None

Patient Information

Patient Name : Husker C
Gender : Male, Neutered
Species : Canine
Type of Imaging : Ultrasound
Book : yes
Status : Complete
Liz Wuz Here : Yes
Code : 07_00086

History

  • Congestive heart failure

Images

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Blood Chemistry

  • Alkaline Phosphatase (SAP), High