case_images: PMC10293747_01
case_images: Images of the penis in a 7-year-old neutered male domestic shorthair cat (case 1) that underwent surgical adrenalectomy for a androstenedione-secreting adrenal tumor. Serum androstenedione concentration prior to surgery was 3.2 nmol/L (RI 0.35-2.1 nmol/L), which decreased to 0.35 nmol/L 3 weeks after surgery. (A) Penile barbs are apparent immediately prior to surgery. (B) The penile barbs had substantially regressed 2 weeks post-adrenalectomy.
case_images: fvets-10-1158142-g0001.jpg
case_images: PMC10293747_01_fvets-10-1158142-g0001.jpg
case_images: F1
case_images: Physical examination identified penile barbs in all male cats (Figure 1), and an enlarged clitoris in one of the three female cats (case 3). The cat was reevaluated at 3 weeks, and at this time, penile barbs had substantially regressed (Figure 1) and serum androstenedione concentration was 0.35 nmol/L (reference interval 0.35-2.1 nmol/L).
case_images: Immunohistochemical labeling showing expression (red chromagen deposit) of steroidogenic enzymes in an androgen-secreting adrenal mass (A, C, E) of a cat, and in normal feline adrenal cortex (B, D, F). The expression of 17alpha-hydroxylase cytochrome P450 [P450c17; (A, B)], cytochrome b5 [b5; (C, D)] and cytochrome P450 21-hydroxylase [P450c21; (E, F)] are shown. (A) The inset shows the entire mass, surrounded by a compressed band of normal cortex (small arrows). Note P450c17 is strongly expressed in the developing tumor (block arrows) but is undetectable in the cortex around it (small arrows). (B) P450c17 expression is localized in the zona fasciculata (ZF) but not the glomerulosa (ZG) of a normal feline adrenal cortex. (C) Note b5 expression in lipid-laden tumor cells at the periphery of the mass. (D) Expression of b5 is detected in the ZG of normal feline adrenal cortex. (E) Expression of P450c21 is strong throughout the compressed cortex (small arrows) surrounding the tumor, which lacks detectable P450c21 expression by comparison (block arrow). (F) Note, the expression of P450c21 also extends throughout all cortical zones to the medulla (M) of the normal feline adrenal cortex.
case_images: fvets-10-1158142-g0002.jpg
case_images: PMC10293747_01_fvets-10-1158142-g0002.jpg
case_images: F2
case_images: Anisocytosis and anisokaryosis were mild with low numbers of mitoses (Figure 2). In one cat (case 3, Figure 2), the neoplastic cells exhibited strong immunoreactivity for 17 alpha-hydroxylase cytochrome P450 (P450c17) and cytochrome b5 (b5), but were negative for 21-hydroxylase cytochrome P450 (P450c21).
case_images: Hematoxylin and eosin staining and immunohistochemical labeling for met-enkephalin and GATA-4 from an androgen-secreting adrenal mass in a cat. (A) [4x] Hematoxylin and eosin stain of adrenocortical carcinoma (asterisk) compressing the adrenal medulla (arrowhead), and non-neoplastic adrenal cortex (x) (B) 100x magnification of the same region. (C) [10x] Medullary chromaffin cells expressing met-enkephalin. The neoplastic cells and non-neoplastic adrenal cortex are negative. (D) [20x] Approximately 60% of the neoplastic cells exhibit nuclear labeling for GATA-4 (arrows). The medullary chromaffin cells and non-neoplastic adrenal cortical cells are negative.
case_images: fvets-10-1158142-g0003.jpg
case_images: PMC10293747_01_fvets-10-1158142-g0003.jpg
case_images: F3
case_images: Although the neoplastic cells in the other 2 cats (cases 1 and 8) were similar in appearance, they either exhibited marked cellular atypia or extended into the capsule thus warranting a designation of carcinoma (Figure 3). In two cats (cases 1 and 8), neoplastic cells were negative for beta-endorphin and met-enkephalin, but exhibited strong nuclear labeling for GATA-4 (Figure 3).