Conn’s Syndrome/Right Adrenal Gland Mass In An 11-Year-Old FS DSH : Our Case Of the Month June 2020

This study confirmed the presence of a right adrenal mass consistent with suspected Conn’s syndrome and hyperaldosteronism. The mass appeared fairly well encapsulated and surgically resectable. Given the size, it does efface the pancreatic limb in the region and is likely causing pancreatitis. A metastatic lesion or adhesion of the mass to the pancreas is thought less likely given the separation from the retroperitoneal cavity; however, this case may benefit from a CT for a more definitive and anatomic evaluation, and assessment of the regional vasculature as well as any possible involvement of the pancreas or other surrounding soft tissues. Alternatively, exploratory laparotomy for adrenalectomy with concurrent evaluation of the pancreas is and option. For any possible involvement, a partial pancreatectomy could also be considered. Consultation with an internal medicine specialist and surgeon was recommended. After discovery of the right adrenal mass the patient was immediately referred to an internist and was seen less than 24 hours later for further discussion of the right adrenal tumor and hypokalemia. Radiographs showed no evidence of metastatic disease. Surgical excision with hospitalization was discussed with fluid therapy and potassium supplementation (optional CT per our surgeon). Supportive care and medical management with oral potassium supplementation (consider spironolactone) was also discussed. Ultimately, the owner elected humane euthanasia in this case as the patient’s quality of life had declined significantly.