Laparoscopic Adrenalectomy for Treatment of Adrenocortical Carcinoma in a Dog
Adrenocortical carcinoma (ACC) is an active cortisol-producing neoplasm that leads to the development of hyperadrenocorticism. Currently, the treatment of choice for ACC is radical adrenalectomy. Laparoscopic adrenalectomy have been performed and stated as a feasible and advantageous approach in case-selected patients.
The aim of the current study was to report a case of successful laparoscopic resection of ACC in a bitch bearing hyperadrenocorticism.
A 9-year-old Beagle bitch was presenting classical signs of hyperadrenocorticism. ACC-related hyperadrenocorticism was suspected based on the results of the low-dose dexamethasone suppression test, followed by serum cortisol and ACTH dosing. Abdominal echography revealed increased volume of the right adrenal gland adrenal and ACC was suspected. The patient was submitted to laparoscopy for exploration and right adrenalectomy. Three abdominal ports were positioned in triangulation on the right hypogastric area and an auxiliary mini-port was placed beside the right-hand instrument port. The adrenal gland was meticulously dissected. Adrenal veins and arteries and the phrenicoabdominal vein were ligated using titanium clips. The gland was withdrawn using extraction bag and port incisions were closed routinely.
The patient convalesced uneventfully and was discharged 48 hours following surgery. The resected mass was assessed histologically and ACC was confirmed. The signs of hyperadrenocorticism were completely ceased approximately two weeks post-op. The patient presented no evidence of recurrence or metastasis in 12 months of follow-up.
Laparoscopic adrenalectomy was effective and allowed for imaging magnification and accurate dissection, besides decreased convalescence period and mild postoperative pain in a bitch.