Left adrenal mass with phrenic invasion in a 10 year old FS Toy Poodle

History

A 10-year-old SF Toy Poodle was presented for evaluation of polyphagia, possibly PU/PD, and markedly elevated ALP activity.

Clinical Differential Diagnosis

Cushing’s disease – pituitary-dependent, adrenal adenoma/carcinoma, iatrogenic

DX

left adrenal mass

Sonographic Differential Diagnosis

left adrenal mass

Image Interpretation

The left adrenal gland presented a focal mass with phrenic vein invasion to the level of the vena cava; however, the vena cava did not appear to be invaded at this time. The left adrenal gland measured 1.42 x 0.92; however, an extended invasion of approximately 2.0 cm into the level of the vena cava at the phrenic vein was noted. There was no capsular escape noted.

Outcome

This is strongly suggestive for pheochromocytoma or adenocarcinoma. LDDST and blood pressure measurements would be recommended with left adrenalectomy. There was no evidence of metastatic disease.