I am interested in people’s experience. I have done lit search and haven’t answered my questions. I found a mass left adrenal in 12 yr old mixed breed. the surgeon removed left adrenal and left kidney since vascular invasion found there was also invasion of surrounding tissue planes and perirenal bleeding. The histopath adrenal cortical carcinoma with infiltration into renal vein.It is one month post op. The remaining adrenal gland was scanned last week by internist and me today. There is some discussion about whether it is normal. When to expect hypertrophy? how much hypertrophy if it occurs? etc. the patient today was not still so video not taken. I have included images anyway.the surgeon felt at time of surgery the right adrenal was normal.
Comments
The caudal pole is near the “top” of the normal range. I guess you would have to compare it to the size prior to surgery. As Hilary one said “what difference does it make”- as long as it is functional and meeting the dogs needs.
I thought same I think the concern was malignancy? The dog did stim >22 last week so plenty of cortisol. Preop also did stim > 22 . Honestly this is not the biggest problem the ole gal has! Thanks for input.
I’m seeing a uniformly hypertrophied gland that maintains sturcture regarding clean capsule and relatively clean corticomedullary junction (arrow). I do not sustpect malignancy on this right gland. You can light up th esutbleties of the cm junction and capsular contour wiht a linear 12 mHz as well and consider power doppler to see if enhanced blood flow to the gland as well as vascular contour as that gets deviated during neoplasia as well. I would expect cpompansatory hypertrophy given the loss of the left gland. if the dog is cushingoiud condier concurrent pdh as well as adh and pdh on occasion run together. regarding mets of the left gland look at the cvc really well, local tissues, left kidney and portal hilus/liver. If any liver nodules pop up the fna them for sure. Consider a BP as well because 50% of cushings dogs are hypertensive so for me its an additional + predictive factor. Just a side note Trilostane will hypertrophy adrenal glands too when being treated for cushings.
Thanks so much!!!