Concomitant multiple myeloma and probable phaeochromocytoma in a cat

Abstract

Case summaryHerein a drug-resistant IgG-lambda-type multiple myeloma associated with probable phaeochromocytoma in a cat is described. A 12-year-old cat presented with weakness, weight loss, progressive blindness and open-mouth breathing, in addition to polyuria and polydipsia of 2 months’ duration. Abdominal ultrasonography revealed a left adrenal mass. Phaeochromocytoma was suspected on the basis of cytology and was associated with systemic hypertension. Biochemistry showed hyperproteinaemia. Serum protein electrophoresis revealed a narrow spike in the gamma region, identified as IgG lambda type at immunoelectrophoresis. Bone marrow cytology revealed an infiltrate with numerous mature plasma cells. The cat was resistant to two different drugs for multiple myeloma and was euthanased 6 months later because of anorexia and persistent poor general condition.Relevance and novel informationThis is the first clinical description of multiple myeloma associated with a suspected phaeochromocytoma in a cat.

Feline abdominal ultrasonography: what’s normal? what’s abnormal? The adrenal glands

“…In 4/5 cases, the left adrenal gland was involved. 90,95,96,98 The ultrasonographic and intraoperative appearance of the adrenal glands in one cat were suggestive of generalised bilateral adrenal enlargement. However, histopathology later revealed the presence of a phaeochromocytoma in the left adrenal gland and an adrenocortical adenoma in the right gland.…”

“…Clinical signs are similar to those reported in the dog and typically non-specific and vague, including weakness, lethargy, anorexia, weight loss, polyuria and polydipsia, which may be paroxysmal due to the episodic nature of catecholamine release. 22,31,91,94,96,98…”

“…22 They are uncommon in the cat and, to date, only a handful of cases have been reported. 22,90,[94][95][96][97][98] In a retrospective study of 33 cats with adrenal masses, only three cats were diagnosed with phaeochromocytomas. 22 Most of the case reports have involved older (>7 years), neutered domestic shorthair cats.…”

“…Clinical signs are similar to those reported in the dog and typically non-specific and vague, including weakness, lethargy, anorexia, weight loss, polyuria and polydipsia, which may be paroxysmal due to the episodic nature of catecholamine release. 22,31,91,94,96,98 While the clinical history and laboratory results may be indicative of a phaeochromocytoma, imaging (usually ultrasound in the cat) is required to demonstrate the presence of an adrenal mass. 95 To the best of the author's knowledge, the ultrasonographic appearance of adrenal phaeochromocytoma has only been described in five cats.…”

“…95 To the best of the author's knowledge, the ultrasonographic appearance of adrenal phaeochromocytoma has only been described in five cats. 90,[95][96][97][98] Where size was given, tumours ranged in diameter from 7.6 mm to 22 mm and they varied from normal to hypoechoic or heterogeneous in echogenicity. In 4/5 cases, the left adrenal gland was involved.…”