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case_images: Feline abdominal ultrasound. The double arrow shows a right adrenal mass measuring 3.5 cm
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case_images: An abdominal ultrasound revealed a right adrenal mass measuring 3.5 cm (Figure 1).
case_images: Feline abdominal ultrasound. The arrow shows a small left adrenal gland (approximately 1 cm)
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case_images: The contralateral (left) adrenal gland was below the RI (approximately 0.2 cm in height, RI 0.35-0.45) (Figure 2).
case_images: Abdominal CT examination, parasagittal image. The arrow shows a mass measuring 5-6 cm, encompassing the right kidney close to the vena cava and aorta
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case_images: The adrenal mass was 5-6 cm in diameter, encompassing the right kidney with adhesions to the caudal vena cava and abdominal aorta (Figures 3 and 4).
case_images: Abdominal CT examination, dorsal image. The arrow shows a mass measuring 5-6 cm, encompassing the right kidney
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case_images: The adrenal mass was 5-6 cm in diameter, encompassing the right kidney with adhesions to the caudal vena cava and abdominal aorta (Figures 3 and 4).
case_images: A right adrenal mass after surgery, which measured 5 cm, isolated from the right kidney and vessels
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case_images: Soft tissue dissection allowed a monobloc resection of the mass (adrenal gland and right kidney) after ligation of the phrenico-abdominal vein, the renal vein, a branch of a right hepatic vein and the renal artery (Figure 5).
case_images: Histological analysis of an adrenal mass at 400x magnification reveals infiltration of the renal capsule by a nodular neoformation that is non-encapsulated and poorly delineated. Tumour proliferation closely mimics the endocrinoid architecture of the corticoadrenal region, with small nests juxtaposed with well-differentiated tumour epithelial cells. These findings strongly suggest corticoadrenal carcinoma
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case_images: Histopathological analysis revealed a corticoadrenal carcinoma (LAPVSO) (Figure 6).
case_images: (a) Serum creatinine, (b) serum potassium and (c) Na:k ratio vs time graph. Day 0 is the cat's first presentation; the arrow is on the day of the surgery. The asterisk represents desoxycorticosterone pivalate injections
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case_images: Electrolytes, serum creatinine and blood pressure had normalised (Figure 7a,b). At postoperative day 25, the cat was clinically normal, and serum potassium, creatinine and blood pressure were stable (4.2 mmol/l, 180.3 micromol/l and 152 mmHg, respectively) (Figure 7a,b). At postoperative day 70, the cat vomited three times a week over a period of 10 days and serum creatinine increased (358 micromol/l) (Figure 7a). Serum potassium also increased (6.9 mmol/l), with a low Na:K ratio (23, RI >27) (Figure 7b,c). Serum creatinine and potassium were 371.3 micromol/l and 5.2 mmol/l, respectively, with an Na:K ratio of 31 (Figure 7) supporting an appropriate dosage interval. At 920 days after diagnosis and 640 days after the last desoxycorticosterone pivalate injection, the cat was clinically normal with serum potassium and sodium within the reference interval (K 4.3 mmol/l, Na 150 mmol/l, Na/K 35) (Figure 7) but persistently elevated creatinine.