Laparoscopic adrenalectomy for management of a functional adrenal tumor in a cat

Rebecca R. Smith, Philipp Mayhew, Allyson C. Berent

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Case Description-A 9-year-old castrated male domestic shorthair cat was examined because of hypertension that persisted after resolution of the patient's hyperthyroidism. Bilateral hypertensive retinopathy, a systolic heart murmur, left ventricular hypertrophy, and tachycardia were present. Clinical Findings-Biochemical analysis revealed mild hypokalemia, normonatremia, high serum creatine kinase activity, high serum aldosterone concentration, and low plasma renin activity consistent with hyperaldosteronism. Hypercalcemia with an associated high serum parathyroid hormone concentration and an exaggerated low-dose dexamethasone suppression test result were consistent with concurrent hyperparathyroidism and hyperadrenocorticism, respectively. Ultrasonographic examination revealed a markedly enlarged left adrenal gland, an abnormally small right adrenal gland, and 2 nodules in the right thyroid and parathyroid glands. Treatment and Outcome-Laparoscopic left adrenalectomy was performed concurrently with right thyroidectomy and parathyroidectomy. Histologic evaluation revealed an adrenal cortical adenoma, thyroid adenoma, and parathyroid adenoma. The cat recovered from surgery without complications. The hypercalcemia and hypertension resolved after surgery. Follow-up echocardiography revealed improvement in the left ventricular hypertrophy. Ultrasonographic examinations performed up to 26 months after adrenalectomy showed no evidence of regrowth of the adrenal mass. The patient survived for 44 months after adrenalectomy with no signs of recurrent hyperaldosteronism or hyperadrenocorticism. Clinical Relevance-Laparoscopic adrenalectomy may be a plausible method for the treatment of unilateral functional adrenal neoplasia in feline patients when diagnostic imaging has ruled out intravascular invasion and metastatic disease. In addition, in a feline patient with hyperthyroidism and hypertension, other endocrine glands should be investigated.

Original languageEnglish (US)
Pages (from-to)368-372
Number of pages5
JournalJournal of the American Veterinary Medical Association
Volume241
Issue number3
DOIs
StatePublished - Aug 1 2012

Fingerprint

Glandular and Epithelial Neoplasms
Adrenalectomy
Cats
Adrenocortical Hyperfunction
cats
adenoma
Hyperaldosteronism
neoplasms
Felidae
hypertension
Hypercalcemia
Left Ventricular Hypertrophy
Hyperthyroidism
Adrenal Glands
hypercalcemia
Hypertension
hyperadrenocorticism
hyperthyroidism
adrenal glands
hypertrophy

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Laparoscopic adrenalectomy for management of a functional adrenal tumor in a cat. / Smith, Rebecca R.; Mayhew, Philipp; Berent, Allyson C.

In: Journal of the American Veterinary Medical Association, Vol. 241, No. 3, 01.08.2012, p. 368-372.

Research output: Contribution to journalArticle

@article{6c722a93bcd5458ba67fb7f525da6004,
title = "Laparoscopic adrenalectomy for management of a functional adrenal tumor in a cat",
abstract = "Case Description-A 9-year-old castrated male domestic shorthair cat was examined because of hypertension that persisted after resolution of the patient's hyperthyroidism. Bilateral hypertensive retinopathy, a systolic heart murmur, left ventricular hypertrophy, and tachycardia were present. Clinical Findings-Biochemical analysis revealed mild hypokalemia, normonatremia, high serum creatine kinase activity, high serum aldosterone concentration, and low plasma renin activity consistent with hyperaldosteronism. Hypercalcemia with an associated high serum parathyroid hormone concentration and an exaggerated low-dose dexamethasone suppression test result were consistent with concurrent hyperparathyroidism and hyperadrenocorticism, respectively. Ultrasonographic examination revealed a markedly enlarged left adrenal gland, an abnormally small right adrenal gland, and 2 nodules in the right thyroid and parathyroid glands. Treatment and Outcome-Laparoscopic left adrenalectomy was performed concurrently with right thyroidectomy and parathyroidectomy. Histologic evaluation revealed an adrenal cortical adenoma, thyroid adenoma, and parathyroid adenoma. The cat recovered from surgery without complications. The hypercalcemia and hypertension resolved after surgery. Follow-up echocardiography revealed improvement in the left ventricular hypertrophy. Ultrasonographic examinations performed up to 26 months after adrenalectomy showed no evidence of regrowth of the adrenal mass. The patient survived for 44 months after adrenalectomy with no signs of recurrent hyperaldosteronism or hyperadrenocorticism. Clinical Relevance-Laparoscopic adrenalectomy may be a plausible method for the treatment of unilateral functional adrenal neoplasia in feline patients when diagnostic imaging has ruled out intravascular invasion and metastatic disease. In addition, in a feline patient with hyperthyroidism and hypertension, other endocrine glands should be investigated.",
author = "Smith, {Rebecca R.} and Philipp Mayhew and Berent, {Allyson C.}",
year = "2012",
month = "8",
day = "1",
doi = "10.2460/javma.241.3.368",
language = "English (US)",
volume = "241",
pages = "368--372",
journal = "Journal of the American Veterinary Medical Association",
issn = "0003-1488",
publisher = "American Veterinary Medical Association",
number = "3",

}

TY - JOUR

T1 - Laparoscopic adrenalectomy for management of a functional adrenal tumor in a cat

AU - Smith, Rebecca R.

AU - Mayhew, Philipp

AU - Berent, Allyson C.

PY - 2012/8/1

Y1 - 2012/8/1

N2 - Case Description-A 9-year-old castrated male domestic shorthair cat was examined because of hypertension that persisted after resolution of the patient's hyperthyroidism. Bilateral hypertensive retinopathy, a systolic heart murmur, left ventricular hypertrophy, and tachycardia were present. Clinical Findings-Biochemical analysis revealed mild hypokalemia, normonatremia, high serum creatine kinase activity, high serum aldosterone concentration, and low plasma renin activity consistent with hyperaldosteronism. Hypercalcemia with an associated high serum parathyroid hormone concentration and an exaggerated low-dose dexamethasone suppression test result were consistent with concurrent hyperparathyroidism and hyperadrenocorticism, respectively. Ultrasonographic examination revealed a markedly enlarged left adrenal gland, an abnormally small right adrenal gland, and 2 nodules in the right thyroid and parathyroid glands. Treatment and Outcome-Laparoscopic left adrenalectomy was performed concurrently with right thyroidectomy and parathyroidectomy. Histologic evaluation revealed an adrenal cortical adenoma, thyroid adenoma, and parathyroid adenoma. The cat recovered from surgery without complications. The hypercalcemia and hypertension resolved after surgery. Follow-up echocardiography revealed improvement in the left ventricular hypertrophy. Ultrasonographic examinations performed up to 26 months after adrenalectomy showed no evidence of regrowth of the adrenal mass. The patient survived for 44 months after adrenalectomy with no signs of recurrent hyperaldosteronism or hyperadrenocorticism. Clinical Relevance-Laparoscopic adrenalectomy may be a plausible method for the treatment of unilateral functional adrenal neoplasia in feline patients when diagnostic imaging has ruled out intravascular invasion and metastatic disease. In addition, in a feline patient with hyperthyroidism and hypertension, other endocrine glands should be investigated.

AB - Case Description-A 9-year-old castrated male domestic shorthair cat was examined because of hypertension that persisted after resolution of the patient's hyperthyroidism. Bilateral hypertensive retinopathy, a systolic heart murmur, left ventricular hypertrophy, and tachycardia were present. Clinical Findings-Biochemical analysis revealed mild hypokalemia, normonatremia, high serum creatine kinase activity, high serum aldosterone concentration, and low plasma renin activity consistent with hyperaldosteronism. Hypercalcemia with an associated high serum parathyroid hormone concentration and an exaggerated low-dose dexamethasone suppression test result were consistent with concurrent hyperparathyroidism and hyperadrenocorticism, respectively. Ultrasonographic examination revealed a markedly enlarged left adrenal gland, an abnormally small right adrenal gland, and 2 nodules in the right thyroid and parathyroid glands. Treatment and Outcome-Laparoscopic left adrenalectomy was performed concurrently with right thyroidectomy and parathyroidectomy. Histologic evaluation revealed an adrenal cortical adenoma, thyroid adenoma, and parathyroid adenoma. The cat recovered from surgery without complications. The hypercalcemia and hypertension resolved after surgery. Follow-up echocardiography revealed improvement in the left ventricular hypertrophy. Ultrasonographic examinations performed up to 26 months after adrenalectomy showed no evidence of regrowth of the adrenal mass. The patient survived for 44 months after adrenalectomy with no signs of recurrent hyperaldosteronism or hyperadrenocorticism. Clinical Relevance-Laparoscopic adrenalectomy may be a plausible method for the treatment of unilateral functional adrenal neoplasia in feline patients when diagnostic imaging has ruled out intravascular invasion and metastatic disease. In addition, in a feline patient with hyperthyroidism and hypertension, other endocrine glands should be investigated.

UR - http://www.scopus.com/inward/record.url?scp=84864193542&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864193542&partnerID=8YFLogxK

U2 - 10.2460/javma.241.3.368

DO - 10.2460/javma.241.3.368

M3 - Article

C2 - 22812475

AN - SCOPUS:84864193542

VL - 241

SP - 368

EP - 372

JO - Journal of the American Veterinary Medical Association

JF - Journal of the American Veterinary Medical Association

SN - 0003-1488

IS - 3

ER -