Advertisement

Surgical management of adrenal gland tumors with and without associated tumor thrombi in dogs: 40 cases (1994–2001)

Andrew E. Kyles BVMS, PhD, DACVS1, Edward C. Feldman DVM, DACVIM2, Hilde E. V. De Cock DVM, PhD, DACVP3, Philip H. Kass DVM, PhD4, Kyle G. Mathews DVM, MS, DACVS5, Elizabeth M. Hardie DVM, PhD, DACVS6, Richard W. Nelson DVM, DACVIM7, Janet E. Ilkiw BVSc, PhD8, and Clare R. Gregory DVM, DACVS9
View More View Less
  • 1 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 2 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 3 Departments of Pathology, Immunology and Microbiology, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 4 Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 5 Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27606.
  • | 6 Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, 27606.
  • | 7 Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 8 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.
  • | 9 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

Abstract

Objective—To compare pathologic findings and results of adrenalectomy for adrenal gland tumors in dogs with and without vena caval tumor thrombi.

Design—Retrospective study.

Animals—40 dogs with adrenal gland tumors.

Procedure—Medical records were examined. An exact logistic regression analysis was used to evaluate associations between tumor type or right-sided versus left-sided tumor involvement and development of caval tumor thrombi and associations between tumor thrombi, tumor type, or right- versus left-sided location and perioperative complications and mortality rate. Survival was compared between dogs with and without tumor thrombi.

Results—Caval thrombi were detected in 25% of dogs, including 3 of 28 (11%) dogs with an adrenocortical tumor and 6 of 11 dogs with a pheochromocytoma. A caval tumor thrombus was detected in 6 of 17 right-sided and 4 of 20 left-sided tumors. Sensitivity and specificity of abdominal ultrasonography for detection of caval thrombi were 80 and 90%, respectively. Intraoperative and postoperative complications developed in 15 and 51% of dogs, respectively. The mortality rate was 22%. There were no significant differences in perioperative morbidity and mortality rates between dogs with and without tumor thrombi.

Conclusions and Clinical Relevance—Caval thrombi associated with adrenal gland tumors are amenable to adrenalectomy and thrombectomy without significantly increased perioperative morbidity and mortality rates, assuming the surgeon is experienced in appropriate techniques. (J Am Vet Med Assoc 2003;223: 654–662)

Abstract

Objective—To compare pathologic findings and results of adrenalectomy for adrenal gland tumors in dogs with and without vena caval tumor thrombi.

Design—Retrospective study.

Animals—40 dogs with adrenal gland tumors.

Procedure—Medical records were examined. An exact logistic regression analysis was used to evaluate associations between tumor type or right-sided versus left-sided tumor involvement and development of caval tumor thrombi and associations between tumor thrombi, tumor type, or right- versus left-sided location and perioperative complications and mortality rate. Survival was compared between dogs with and without tumor thrombi.

Results—Caval thrombi were detected in 25% of dogs, including 3 of 28 (11%) dogs with an adrenocortical tumor and 6 of 11 dogs with a pheochromocytoma. A caval tumor thrombus was detected in 6 of 17 right-sided and 4 of 20 left-sided tumors. Sensitivity and specificity of abdominal ultrasonography for detection of caval thrombi were 80 and 90%, respectively. Intraoperative and postoperative complications developed in 15 and 51% of dogs, respectively. The mortality rate was 22%. There were no significant differences in perioperative morbidity and mortality rates between dogs with and without tumor thrombi.

Conclusions and Clinical Relevance—Caval thrombi associated with adrenal gland tumors are amenable to adrenalectomy and thrombectomy without significantly increased perioperative morbidity and mortality rates, assuming the surgeon is experienced in appropriate techniques. (J Am Vet Med Assoc 2003;223: 654–662)