12 yr old FS yorkie-poo with anorexia for 3 weeks, intermittant vomiting of food x 2 weeks
2 weeks ago chem profile was wnl,CBC showed a neutrophilia, U/A showedproteinuria PLN, 8-18-21 labs rerun chem pancreatic lipase WNL
Abdominal US shows a 5.0cm hypoechoic mass in the left abdomen impining upon the cranial pole of the left kidney, clumping echogenic fat adjacent to the mass, stomach, and liver, nodular hepatic parenchyma, bilateral loss of renal corticomedullary defintion.
Differential diagnoses for the mass include pancreatic carcinoma, severe pancreatitis, pancreatic abscess, other neoplasia, metastatic lymph node, and less likely adrenal mass (wrong side of renal artery).
US guided FNA of the mass showed chronic neutrophilic inflammation and mineralization. The pathologist suggests core biopsies next but since this is likely pancreatic (and less likely adrenal) in origin, I am wondering if exploratory laparotomy would be a better choice.