Presenting clinical signs: bilateral hyphema, sudden onset blindness. Hypertensive. Chronic azotemia. BUN 41, Crea 2.0, ALKP 1180.
Presenting clinical signs: bilateral hyphema, sudden onset blindness. Hypertensive. Chronic azotemia. BUN 41, Crea 2.0, ALKP 1180.
The right adrenal gland was uniform with no evident pathology. The right adrenal gland measured 3.38 x 0.99 cm. The left adrenal gland was comprised of a mineralizing mass that measured 6.15 x 5.06 cm.
The kidneys presented moderate degenerative changes and undulating contour. Occasional, anechoic cortical cyst and moderate interstitial nephrosis pattern. The right kidney measured 8.35 cm. The left kidney measured 7.5 cm with pyelectasia that measured 0.42 cm. The pancreas presented mixed, hypoechoic nodular changes and hyperechoic, ill defined surrounding fat.
Occasionally pheochromocytomas can mineralize. If the USPG is lessthan 1.020 then LDDST is recommended. Surgical consultation is recommended with expectations toward partial cavotomy. There was no obvious metastatic disease noted. Three view chest radiographs ar warranted. The hypertension is likely driving the kidneys in this patient. Ace inhibitors and Phenoxybenzamine are recommended to stabilize the kidneys for potential surgical intervention. Gven the pyelectasia of the left kidney, urine culture would be warranted as well as treatment for any evidence of urinary tract infection.
