Presentation
Presents with lethargy, polyuria/polydipsia, and weight gain. History of low grade mammary adenocarcinoma that was resected with good margins 1 year previously. Adopted 5 years ago.
Patient Data
The liver is markedly enlarged and is displacing the gastric axis caudally. Just medial to the right kidney there is a soft tissue mass with cranial multifocal mineralization. The mass is visible both on the lateral and the v/d projections. The patient has a pendulous abdomen. The liver is enlarged with rounded margins. There is adequate abdominal serosal detail.
In the portion of the thorax included, there are multiple soft tissue opacity nodules and masses throughout the lungs.
Case Discussion
Right adrenal neoplasia with caudal vena cava invasion and tumor thrombus was seen on ultrasound. Multiple hepatic and thoracic nodules (presumed metastases, adrenal or mammary in origin). Hepatomegaly was secondary to hyperadrenocorticism.
Hyperadrenocorticism was confirmed, indicating the tumor could be an adenoma or carcinoma. Mineralization does not differentiate adenoma from carcinoma. While pheochromocytomas are more often vascularly invasive, they do not cause hyperadrenocorticism.
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