Hi All,
Simba's mom here. HELP please. After reading this forum there is such a huge support for Cushing's and adrenal tumors i thought i would at least try to get help understanding what i am up against! Simba is the love of my life literally he is a 13.5 year old lab mix who was just diagnosed with an Adrenal mass and invasion to the vena cava. He had no other signs except i noticed increased thirst which didn't know it was a sign until now. They were checking him for Cushings at least they mentioned this.. This visit was for an ultrasound as a followup to a previous emergent surgery to remove his spleen and hepatocellular carcinoma as noted in his history. Then we rushed over to get a CT scan and see below for the results. They say his vena cava involvement is the biggest they've ever seen?? Is this big to this group? My surgeon doesn't think he would make it through surgery but is willing to if I give the go ahead. Can you guys review and tell me your thoughts? work up other than regular CBC with liver enzymes slightly elevated with protein in urine. BP was 170. I do not know how aggressive i should be and do not understand what i am up against.
History: Previous hepatic lobectomy for hepatocellular carcinoma and splenectomy for
lymphoid follicular hyperplasia. On recheck, ultrasound evaluation identified a right adrenal
mass with invasion into the cranial vena cava.
Description: Within the abdomen, the right adrenal gland is 2.1 cm in size. This mass
extends into the caudal vena cava distending the lumen of the caudal vena cava to 3.5 cm in
diameter. The phrenicoabdominal vein is also distended dorsally. This extension of the
mass in the caudal vena cava extends for a length of 8.8 cm. The left adrenal gland is 1.3
cm thick. The hepatic lymph nodes are mildly larger (0.9 cm). Within the gallbladder, there
is mild soft tissue attenuating sediment. No abnormalities within the liver are seen. The
spleen is not identified. The right kidney is mildly irregular shaped and the left kidney is
unremarkable. In the right prescapular region, there is a 10.3 cm x 5.4 cm, striated, fat
attenuating mass. Multiple lipomas are present within the thoracic and abdominal body wall.
No evidence of lymphomegaly is seen. Within the thorax, no abnormalities are seen. The
pulmonary parenchyma and pulmonary vasculature have a normal appearance. The heart
has normal size and appearance. No thoracic musculoskeletal abnormalities are seen. In
the right caudal gluteal region, there is a 1.2 cm soft tissue nodule just dorsal to the caudal
thigh muscles
Conclusion:
1. Right adrenal mass with invasion into the right phrenicoabdominal vein and caudal vena
cava
2. Mild left adrenomegaly - possible reactive hyperplasia
3. Hepatic lymphomegaly - possible metastatic disease from the previous hepatocellular
carcinoma
4. Presumed liposarcoma, right prescapular region
5. Soft tissue nodule, right caudal thigh - nonspecific
6. Unremarkable thorax