Our Summary

This research paper discusses a case where a tumor was successfully removed from a dog using a special type of imaging technique. The dog, a 10-year-old poodle, was brought in due to a mass in its abdomen and repeated vomiting. The vets discovered tumors in the dog’s spleen and left adrenal gland through CT scans. The dog was diagnosed with pheochromocytoma, a rare tumor that usually starts in the adrenal glands. To treat this, the vets performed surgery to remove the spleen and the left adrenal gland.

Before the surgery, they injected the dog with a substance called indocyanine green (ICG) which helped them to clearly see the boundaries of the tumor during the surgery. This made the surgery safer and more effective as it reduced the risks related to anesthesia and helped ensure complete removal of the tumor.

A year after the surgery, the dog showed no signs of the tumor coming back or spreading to other parts of the body. This is the first known case where ICG imaging was used in this way in veterinary medicine. The success of this case shows that ICG fluorescence imaging can be a useful technique for treating adrenal tumors in animals.

FAQs

  1. What is the significance of using indocyanine green (ICG) fluorescence imaging in the surgical removal of a pheochromocytoma in a dog?
  2. How does the use of ICG fluorescence imaging aid in the surgical management of adrenal tumors in veterinary medicine?
  3. What were the results of the surgical removal of a pheochromocytoma using intraoperative ICG imaging, according to the case presented in the article?

Doctor’s Tip

A doctor might tell a patient undergoing adrenalectomy to discuss with their healthcare provider the possibility of using indocyanine green (ICG) fluorescence imaging during surgery. This imaging technique can help visualize tumor margins and aid in complete resection, potentially reducing anesthesia-related risks and improving surgical outcomes.

Suitable For

Patients who are typically recommended adrenalectomy include those with adrenal tumors such as pheochromocytoma, adrenal cortical carcinoma, and adrenal adenoma. In the case of pheochromocytoma, patients may present with symptoms such as hypertension, palpitations, sweating, and headache. Diagnosis is often made based on plasma or urine catecholamine levels. Adrenalectomy may be recommended for patients with symptomatic or hormonally active adrenal tumors, as well as for those with tumors that are large in size or suspected to be malignant. In cases where the tumor is causing symptoms or is at risk of metastasis, surgical removal is often the treatment of choice.

Timeline

Before adrenalectomy:

  1. Patient presents with symptoms such as abdominal mass and vomiting.
  2. Diagnostic tests such as computed tomography and plasma normetanephrine levels are performed to confirm diagnosis of pheochromocytoma.
  3. Surgery is recommended as treatment option.

After adrenalectomy:

  1. Indocyanine green (ICG) is administered intravenously 24 hours prior to surgery.
  2. ICG fluorescence imaging is used during surgery to aid in visualization of tumor margins and ensure complete resection.
  3. Patient undergoes total splenectomy and left adrenalectomy.
  4. No evidence of recurrence or metastasis is observed for 12 months post-surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about adrenalectomy include:

  1. What is the reason for recommending adrenalectomy in my case?
  2. What are the potential risks and complications associated with adrenalectomy?
  3. How will the surgery be performed and what type of anesthesia will be used?
  4. What is the expected recovery time after adrenalectomy?
  5. Will I need any additional treatments or medications after the surgery?
  6. What is the likelihood of recurrence or metastasis of the tumor after adrenalectomy?
  7. Are there any lifestyle changes or dietary restrictions I should follow post-surgery?
  8. What follow-up appointments or tests will be necessary to monitor my condition after adrenalectomy?
  9. Are there any alternative treatment options to consider before proceeding with adrenalectomy?
  10. Can you provide more information about the use of indocyanine green (ICG) fluorescence imaging during adrenalectomy and how it can benefit the surgical outcome?

Reference

Authors: Yu SY, Lee S. Journal: J Vet Sci. 2024 Jul;25(4):e53. doi: 10.4142/jvs.24146. PMID: 39083205