other adrenal tumours

Question 1

what are the tumours of the adrenal gland?

Answer 1

Cortex:
- Functional adrenal neoplasia (non-cortisol) - Aldosterone secreting “aldosteronoma” - Conn’s syndrome

• Aberrant adrenal receptor activity
  
  • Food (GIP) associated
• “Atypical” hyperadrenocorticism
• Ectopic ACTH
• Congenital adrenal hyperplasia
• “Alopecia X”
  
  • ?non-adrenal

Medulla
- Phaeochromocytoma

Question 2

What will you see when you have a Functional adrenocortical tumours (non-cortisol) that is glucocorticoid like?
how are they diagnosed?
what are the treatment options?

Answer 2

• Presentation
  
  • Similar to HAC incl stress leukogram, ACTH suppression etc
• Diagnosis
  
  • ACTH stim
    
    • 17OP, androstenedione
    • Mid range or low cortisol with minimal change
• Treatment
  
  • Surgical (preferred)
  • Medical

Question 3

What will you see when you have a Functional adrenocortical tumours (non-cortisol) that is mineralocorticoid like?
how are they diagnosed?
what are the treatment options?

Answer 3

• Presentation
  
  • Related to hypokalaemia
  • Muscle weakness
  • Cats ventroflexion of neck
• Diagnosis
  
  • ACTH stim
    
    • aldosterone
• Treatment
  
  • Surgical (preferred)
  • Medical
    
    • Spironolactone

Question 4

what are the clinicla signs of phaechromocytoma?

Answer 4

Weight loss
Poor appetite
Tachypnoea
Polyuria/Polydipsia
Tachycardic
Hypertension
Panting
Restlessness
High blood glucose - insulin resistance

Question 5

what is the diagnosis and treatment of phaechromocytoma?

Answer 5

• Maybe confused with hyperadrenocorticism
  
  • PU/PD/Panting
  • Adrenal mass on imaging
  • Hyperglycaemia
• May be diagnosed post-surgically - Histology – Tx for ADHAC
• Pre-surgical diagnosis - Urinary catecholamine metabolites
• Treatment – Surgical - Local vessel invasion
• Medical – symptomatic and pre-surgical
  
  • Adrenoceptor antagonists (Sympatholytics)
  • Phenoxylbenzamine (alpha)
  • Propanolol (Beta)