Leshinsky Jana, Beatty Julia A, Fawcett Anne, Voss Katja, Makara Mariano, Krockenberger Mark B, Barrs Vanessa R
Valentine Charlton Cat Centre, Faculty of Veterinary Science, University of Sydney, NSW, Australia.
Sydney Animal Hospitals - Inner West, Stanmore, NSW, Australia.
JFMS Open Rep. 2016 Jan 25;2(1):2055116915624448. doi: 10.1177/2055116915624448. eCollection 2016 Jan-Jun.
A 12-year-old, male neutered domestic shorthair cat was referred for investigation of suspected hyperaldosteronism due to persistent hypokalaemia, hindlimb ataxia, weakness of 1 month's duration and a left adrenal mass that was detected on abdominal ultrasound. Neurological examination findings at referral were suggestive of a concurrent left forebrain lesion. Hyperaldosteronism and concurrent hyperprogesteronism were confirmed on endocrine testing. On computed tomography (CT) of the abdomen and thorax there was no evidence of local vascular invasion by the adrenal mass or of metastatic disease. CT and magnetic resonance imaging featured a large, focal rim-enhancing extra-axial left forebrain lesion consistent with a meningioma. Surgical excision of the forebrain mass was followed by adrenalectomy 2 weeks later. The tumours were classified on histopathology as a psammomatous meningioma and an adrenocortical adenocarcinoma, respectively. Immunohistochemical staining of the meningioma confirmed the presence of progesterone receptors. The cat remains well 2 years later.
In humans, elevated serum progesterone levels have been associated with rapid growth of meningiomas due to the presence of progesterone receptors on the tumour. This is the first report of a cat with a progesterone and aldosterone-secreting adrenocortical adenocarcinoma and a concurrent meningioma. Clinicians should be aware of the potential effect of elevated progesterone on meningiomas in cats.
一只12岁已绝育的雄性家养短毛猫因持续性低钾血症、后肢共济失调、持续1个月的虚弱以及腹部超声检查发现左肾上腺肿块而被转诊以调查疑似醛固酮增多症。转诊时的神经学检查结果提示同时存在左前脑病变。内分泌检测证实存在醛固酮增多症和同时存在的孕酮增多症。腹部和胸部计算机断层扫描(CT)未发现肾上腺肿块有局部血管侵犯或转移疾病的证据。CT和磁共振成像显示左前脑有一个大的、局灶性边缘强化的轴外病变,与脑膜瘤一致。前脑肿块手术切除2周后进行了肾上腺切除术。肿瘤在组织病理学上分别被分类为砂粒状脑膜瘤和肾上腺皮质腺癌。脑膜瘤的免疫组织化学染色证实存在孕酮受体。2年后这只猫状况良好。
在人类中,由于肿瘤上存在孕酮受体,血清孕酮水平升高与脑膜瘤的快速生长有关。这是首例患有分泌孕酮和醛固酮的肾上腺皮质腺癌并同时患有脑膜瘤的猫的报告。临床医生应意识到孕酮升高对猫脑膜瘤的潜在影响。