Case Study

Left adrenal mass with CVC invasion and a concurrent gastric foreign body in a 10 year old FS Bull Mastiff

A 10-year-old FS Bull Mastiff dog with a history of urinary tract infections was presented for vomiting, polyuria/polydypsia, and pollakiuria. The urine appeared turbid, and analysis revealed isosthenuria, proteinuria, pyuria, and hematuria. Urine culture yielded E.coli. Abnormalities on CBC and serum biochemistry were monocytosis, mildly elevated ALP activity, and elevated lipase.

DX

Left adrenal mass with CVC invasion, concurrent gastric foreign body

Sonographic Differential Diagnosis

Invasive left adrenal mass – adenocarcinoma, pheochromocytoma less likely. Concurrent gastric foreign body.

Image Interpretation

The left adrenal region is occupied by a large hypoechoic mass invading the phrenic vein and entering the vena cava cranially and caudally to the iliac bifurcation. Single image of the stomach shows a concurrent fluid absorbing fabric type foreign body creating an echogenic shadow in the gastric lumen.

Outcome

The UTI was treated with a long term course of antibiotics. The patient subsequently defecated a sock, which resulted in cessation of the vomiting. The patient was lost to follow-up.