- 11 year old JRT presented with pu/pd and incontinence
- Urine sg 1.005, later concentrated following fasting/water being withheld to 1.020, laboratory urine sg 1.004
- Bloods: ALP>>ALT, mild increase in resting bile acids, cholesterol normal, ACTH stim wnl
- Was started on incurin and incontinence resolved, owner thinks not now polydipsic
- Abdominal ultrasound showed large (3x3cm) heterogenous liver mass and a few smaller hyperechoic nodules
- Left adrenal gland was enlarged with irregular contour, right adrenal gland normal
- 11 year old JRT presented with pu/pd and incontinence
- Urine sg 1.005, later concentrated following fasting/water being withheld to 1.020, laboratory urine sg 1.004
- Bloods: ALP>>ALT, mild increase in resting bile acids, cholesterol normal, ACTH stim wnl
- Was started on incurin and incontinence resolved, owner thinks not now polydipsic
- Abdominal ultrasound showed large (3x3cm) heterogenous liver mass and a few smaller hyperechoic nodules
- Left adrenal gland was enlarged with irregular contour, right adrenal gland normal
- Do you think the liver masses are significant, is the large mass most likely an adenoma or adenocarcinoma
- Can you have unilateral adrenomegaly with pituitary hyperadrenocorticism?
– left adrenal
Comments
you can have pdh with
you can have pdh with unilateral enlargement and its usually uniform but emerging left adrenal carcinoma possible here so need to monitor. The liver mass has aspects of carcinoma. right intercostal position SDEP 12 or 13 should give access to fna it. Not resectable in that position though and likely 2 different issues.
Thanks EL. What are the
Thanks EL. What are the aspects that make you think carcinoma, size and heterogenous nature? The owner is considering biopsy.
Is it the lobe position that
Is it the lobe position that makes it non-resectable and which liver lobes are potentially resectable?
Left liver and caudate you
Left liver and caudate you can cut out then the rest is dicey because of vital structures. Carcinoma based on echotexture and deviations form curvilinear patterns as opposed to hepatoma which barely changes form normal liver architecture.