Willow's operation pictures


Growth near bladder.




Growth near bladder.




Growth.




Laboratory report

HISTORY

Abdominal pain. Dorsal alopecia. Regularly impacted anal sacs. Large amounts of abdominal fat. Cardiomegaly. Remove cystic looking growth from caudal L kidney.

REPORT

Adrenal Cortical Carcinoma

Suggested Diagnosis Guarded Prognosis

This para-renal, cystic, abdominal mass has the histological hallmarks of an adrenal cortical carcinoma. It is composed of pleomorphic cell populations comprising large, polyhedral cells with abundant, eosinophilic, finely vacuolated (microvesicular) cytoplasm; smaller, more basophilic cells; and large cells with clear, or macrovesicular, cytoplasm. These three basic cell types are present in variable proportions as mixed sheets, or as smaller nests or cords of a single cell type, surrounded and separated by a fairly generous amount of fibrous stroma. There is considerable nuclear pleomorphism, with occasional atypia, and a few mitotic figures can be found, but the mitotic index is not particularly high. A few variable-sized cysts are present within the mass, which is encapsulated, with no evidence of infiltration into the surrounding connective tissue. The histological appearance is consistent with adrenal cortical carcinoma, though the location described, at the caudal edge of the kidney, is atypical.

According to many sources, adrenal cortical tumours are the second most common neoplasms in ferrets, after islet cell tumours of the pancreas. As with islet cell tumours they are more frequently recorded in spayed females and castrated males than entire animals. Adenomas are small and usually present as a discrete nodule within an otherwise unremarkable gland, while carcinomas are large, frequently completely effacing the normal architecture of the gland. Growth of proliferative tissue beyond the capsule of the gland, however, is not a reliable indicator of malignancy as it may be seen with adenoma or even just hyperplasia, as well as with carcinoma. Distant metastasis apparently occurs infrequently, so early surgical removal of the affected gland can be curative, even with carcinoma, especially when there is no overt evidence of extracapsular invasion, as here. Nevertheless, as the tumour is potentially malignant, a guarded prognosis is appropriate.