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犬肾上腺肿瘤的成功剖腹乙醇消融术。

Successful laparotomic ethanol ablation for an adrenal tumour in a dog.

机构信息

Shinagawa WAF Animal Hospital, Tokyo, Japan.

JASMINE Veterinary Cardiovascular Medical Center, Kanagawa, Japan.

出版信息

Vet Med Sci. 2024 Sep;10(5):e70020. doi: 10.1002/vms3.70020.

Abstract

Adrenalectomy is the gold standard for canine adrenal tumours, but not always recommended due to patient age, underlying conditions and perioperative mortality. Ethanol ablation is an alternative in human medicine for poor surgical candidates. A 13-year-old neutered female toy-poodle with hypercortisolism presented with severe haematuria. Ultrasonography revealed left adrenal and right kidney tumours. Due to high surgical risk, simultaneous laparotomic right nephroureterectomy and ethanol ablation of the left adrenal tumour were performed. Post-ethanol injection complications included transient hypertension and arrhythmia, which resolved spontaneously. The adrenal tumour size decreased within 2.5 months, and cortisol levels normalised within 8 days, remaining stable for 12 months. No hypercortisolism signs were observed without trilostane until death from renal insufficiency. Autopsy showed that the ablated left adrenal gland was an adrenocortical tumour and had shrunk. Ethanol ablation may be a feasible alternative to adrenalectomy for high-risk canine patients.

摘要

肾上腺切除术是犬肾上腺肿瘤的金标准,但由于患者年龄、基础疾病和围手术期死亡率等因素,并非总是推荐使用。乙醇消融术是人类医学中针对手术高风险患者的一种替代疗法。一只 13 岁已绝育的雌性玩具贵宾犬,患有库欣综合征,出现严重血尿。超声检查显示左侧肾上腺和右侧肾脏肿瘤。由于手术风险高,同时进行了剖腹式右肾输尿管切除术和左侧肾上腺肿瘤乙醇消融术。乙醇注射后的并发症包括短暂性高血压和心律失常,这些并发症均自行缓解。2.5 个月内肾上腺肿瘤体积缩小,皮质醇水平在 8 天内恢复正常,12 个月内保持稳定。在没有曲洛司坦的情况下,没有观察到库欣综合征的迹象,直至因肾功能不全而死亡。尸检显示,消融的左侧肾上腺是一个肾上腺皮质肿瘤,已经缩小。乙醇消融术可能是一种针对高危犬只患者的可行的肾上腺切除术替代疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/11406512/d4c8f23d5fb5/VMS3-10-e70020-g003.jpg

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