J Vet Sci.  2017 Mar;18(1):105-109. 10.4142/jvs.2017.18.1.105.

Repetitive ultrasonographic assessment of adrenal size and shape changes: a clue for an asymptomatic sex hormone-secreting adenoma

• Yoon S
• Oui H
• Lee JH
• Son KY
• Cho KO
• Choi J

• KMID: 2412595
• DOI: http://doi.org/10.4142/jvs.2017.18.1.105

Abstract

Diagnosis of an adrenal tumor without typical clinical signs related to hyperadrenocorticism and elevated alkaline phosphatase is challenging. This report describes a sex hormone-secreting adrenal tumor in a 10-year-old castrated male Shih Tzu evaluated through repetitive ultrasonographic examination. An adrenocorticotropic hormone stimulation test revealed elevated concentrations of androstenedione and 17-hydroxyprogesterone but a normal cortisol concentration. A mass was surgically excised and adenoma was diagnosed histopathologically. In the present case, adrenal tumor was strongly suspected based on a gradual increase in adrenal size and a change from peanut shape to an irregular mass on repetitive ultrasonography. Repetitive ultrasonographic examination of the adrenal gland is recommended when an abnormal ultrasonographic appearance of adrenal gland is identified, even in an asymptomatic dog.

Keyword

adrenal gland neoplasms; clinical signs; diagnostic imaging; sex hormone

MeSH Terms

Adenoma/diagnostic imaging/pathology/surgery/*veterinary
Adrenal Gland Neoplasms/diagnostic imaging/pathology/surgery/*veterinary
Animals
Dog Diseases/*diagnostic imaging/pathology/surgery
Dogs
Male

Figure

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  Fig. 1 Right lateral abdominal radiographs of the dog at first presentation (A) and approximately 20 months later (B). Note the increased liver size in (B) compared with that in (A). Liver size was determined based on the gastric axis (white line).

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  Fig. 2 Serial ultrasonography of the right adrenal gland at the first presentation (A), at 2 months (B), and approximately 20 months later (C). The size of the right adrenal gland (arrow) had increased and had changed to form a mass-like lesion with heterogeneous echotexture (*) and an irregular margin.

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  Fig. 3 Transverse image (A) and multiplanar reconstructed oblique sagittal plane image (B) from post-contrast abdominal computed tomography. Right adrenal mass was close to the wall of the caudal vena cava but did not invade it. Ao, aorta; RK, right kidney; CVC, caudal vena cava; M, mass.

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  Fig. 4 Representative image of histopathologic findings of the right adrenal tumor. Tumor cells were large and polyhedral with prominent nuclei and densely eosinophilic or had markedly vacuolated cytoplasm. H&E stain. Scale bar = 500 µm.

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