Clinical findings, diagnostics and outcome in 33 cats with adrenal neoplasia (2002–2013)

Daniel, Gideon; Mahony, Orla M.; Markovich, Jessica E.; Appleman, Elizabeth H.; Monaghan, Kelly; Lawrence, Yuri A.; Fiocchi, E; Weaver, Kelli E.; Johnston, Andrea N.; Barton, Bruce

doi:10.1177/1098612x15572035

Cited by 44 publications

(109 citation statements)

References 38 publications

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“…In this small cohort of cats undergoing laparoscopic excision of noninvasive unilateral adrenal neoplasms, only 1 of 7 (14%) cats with complete LA died perioperatively. This result compares favorably with open adrenalectomy, a procedure reported to carry a mortality rate of 26% (14/53 cats) within 2 weeks after surgery . Complications associated with open adrenalectomy include hemorrhage, sepsis, hypotension, pancreatitis, postoperative hypoadrenocorticism, metabolic acidosis, acute kidney injury, lethargy, anorexia, and hepatic lipidosis .…”

Section: Discussionmentioning

confidence: 72%

“…Therefore, the treatment of choice for unilateral functional adrenal tumors without evidence of intravascular invasion and metastatic disease is adrenalectomy . The few studies that focus on open adrenalectomy in cats report postoperative complications such as hemorrhage, sepsis, hypotension, pancreatitis, metabolic acidosis, hypoadrenocorticism, lethargy, anorexia, and hepatic lipidosis …”

Section: Introductionmentioning

confidence: 99%

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Outcome of laparoscopic adrenalectomy for resection of unilateral noninvasive adrenocortical tumors in 11 cats

et al. 2017

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Objective: To describe the technique and outcomes of laparoscopic adrenalectomy (LA) in cats with adrenocortical neoplasia.Study design: Retrospective case series.Animals: Eleven client-owned cats with unilateral adrenal tumors.Methods: Medical records of cats that underwent LA for unilateral functional adrenal tumors at 3 veterinary teaching hospitals were reviewed. Data collected included signalment, clinical signs, physical examination findings, diagnostic imaging results, preoperative laboratory tests, laparoscopic port placement and techniques, duration of anesthesia and surgery, complications, concomitant procedures, need for conversion to an open celiotomy, histopathological diagnosis, and postoperative survival.Results: Eleven cats were included, 5 with right-sided and 6 with left-sided tumors. Tumors were aldosterone-secreting (n 5 8), progesterone-secreting (n 5 2), or testosterone-secreting (n 5 1). Adrenalectomy was successfully performed in all 11 cats although 4 cases required conversion to an open celiotomy, due to poor visualization (n 5 2), close adherence of the tumor to the caudal vena cava (n 5 1), and inability to maintain adequate pneumoperitoneum (n 5 1). Ten of the 11 cats were discharged from the hospital, with a median survival time of 803 days (range 467-1123 days). One cat died from severe pancreatitis and cardiogenic pulmonary edema. Conclusion:Adrenalectomy can be performed in cats via laparoscopy but is technically challenging, and associated with a relatively high conversion rate (36%).

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Outcome of laparoscopic adrenalectomy for resection of unilateral noninvasive adrenocortical tumors in 11 cats

et al. 2017

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“…10 A retrospective study of 33 cats with adrenal masses identified 17 carcinomas, 13 adenomas and three pheochromocytomas but no cases of lymphoma. 11 The single reported case study of two cats with hypoadrenocorticism as a manifestation of adrenal lymphoma identified multiple sites of metastasis, with evidence such as abdominal effusion or a mass effect present. 10 A retrospective evaluation of metastatic tumors to the adrenal glands in domestic animals identified bilateral masses in 50% of cats, and lymphoma was identified as one of the metastasizing tumors.…”

Section: Discussionmentioning

confidence: 98%

Primary adrenal lymphoma causing hypoaldosteronism in a cat

Romine¹,

Kozicki²,

Elie³

2016

Journal of Feline Medicine and Surgery Open Reports

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Case summaryA 10-year-old, 5.1 kg (11.2 lb), male castrated cat was presented with signs of lethargy and decreased appetite at home after being previously healthy. Serum biochemical analysis identified normokalemia (5.1 mmol/l; reference interval [RI] 3.4–5.6 mmol/l) and severe hyponatremia (123 mmol/l; RI 145–158 mmol/l), with an Na/K ratio of 24 (RI 32–41). Baseline serum cortisol was low to normal, but serum aldosterone was markedly decreased with a pre-adrenocorticotropic hormone stimulation concentration of 13 pmol/l (RI 194–388 pmol/l) and post-adrenocorticotropic hormone stimulation concentration of 21 pmol/l (RI 277–721 pmol/l). Hematologic and biochemical analyses were otherwise unremarkable. Abdominal ultrasound revealed bilaterally enlarged adrenal glands with no other abnormalities noted; thoracic radiographs also did not identify any signs of metastasis. Fine-needle aspiration was strongly suggestive of lymphoma of the adrenal glands, and PCR for antigen receptor rearrangement was positive for B-cell clonal expansion; based on these findings, a diagnosis of primary adrenal B-cell lymphoma was made. Stable disease was achieved for a short period of time following vincristine, cyclophosphamide, prednisolone and fludrocortisone therapy, followed by progressive adrenal enlargement and electrolyte derangements that responded to neither doxorubicin nor adjustments in fludrocortisone dosage. Ultrasonographic metastasis was not identified at any time, and other organ derangements were not noted on hematologic or biochemical analyses. The cat was euthanized 55 days after initial presentation.Relevance and novel informationThis is the first report of primary adrenal lymphoma in a cat, with presenting signs compatible with hypoaldosteronism. Lymphoma should be a differential for cats presenting with adrenal enlargement or clinical signs and biochemical changes consistent with hypoaldosteronism or hypoadrenocorticism.

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“…Phaeochromocytomas are extremely rare tumours in domestic animals and to the best of the author's knowledge only eight cases of feline phaeochromocytoma are reported in the peer-reviewed literature. [5][6][7] Phaeochromocytomas are often malignant neoplasias, with a median survival time of 20 weeks. 7 Clinical signs are secondary to catecholamine-induced hypertension or due to the presence of a space-occupying mass, and include weakness, collapse, open-mouth breathing, muscle tremors, restlessness, and polydipsia and polyuria.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Phaeochromocytomas are often malignant neoplasias, with a median survival time of 20 weeks. 7 Clinical signs are secondary to catecholamine-induced hypertension or due to the presence of a space-occupying mass, and include weakness, collapse, open-mouth breathing, muscle tremors, restlessness, and polydipsia and polyuria. 5,7 However, hypertension is not always demonstrated as catecholamine secretions may be paroxysmal.…”

Section: Discussionmentioning

confidence: 99%

Concomitant multiple myeloma and probable phaeochromocytoma in a cat

Cervone¹

2017

Journal of Feline Medicine and Surgery Open Reports

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Case summaryHerein a drug-resistant IgG-lambda-type multiple myeloma associated with probable phaeochromocytoma in a cat is described. A 12-year-old cat presented with weakness, weight loss, progressive blindness and open-mouth breathing, in addition to polyuria and polydipsia of 2 months’ duration. Abdominal ultrasonography revealed a left adrenal mass. Phaeochromocytoma was suspected on the basis of cytology and was associated with systemic hypertension. Biochemistry showed hyperproteinaemia. Serum protein electrophoresis revealed a narrow spike in the gamma region, identified as IgG lambda type at immunoelectrophoresis. Bone marrow cytology revealed an infiltrate with numerous mature plasma cells. The cat was resistant to two different drugs for multiple myeloma and was euthanased 6 months later because of anorexia and persistent poor general condition.Relevance and novel informationThis is the first clinical description of multiple myeloma associated with a suspected phaeochromocytoma in a cat.

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Clinical findings, diagnostics and outcome in 33 cats with adrenal neoplasia (2002–2013)

Cited by 44 publications

References 38 publications

Outcome of laparoscopic adrenalectomy for resection of unilateral noninvasive adrenocortical tumors in 11 cats

Outcome of laparoscopic adrenalectomy for resection of unilateral noninvasive adrenocortical tumors in 11 cats

Primary adrenal lymphoma causing hypoaldosteronism in a cat

Concomitant multiple myeloma and probable phaeochromocytoma in a cat

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