Gynaecomastia in a male neutered cat with an adrenal tumour and associated hyperprogesteronism, hypercortisolism and hyperaldosteronism

Abstract

Case summary A 7-year-old male neutered domestic longhair cat was presented with chronic progressive gynaecomastia, polydipsia, polyphagia, weight loss and poor fur regrowth. Sexualised behavioural changes were not reported and virilisation was not present on physical examination. Pertinent haematology, biochemistry and urinalysis findings at the time of referral included mild hypokalaemia. Left adrenomegaly and mild prostatomegaly were identified on a CT scan. Evaluation of adrenal hormones with a low-dose dexamethasone suppression test, serum progesterone, testosterone, oestradiol, plasma aldosterone, renin, plasma metanephrine and normetanephrine measurement supported a diagnosis of hyperprogesteronism, hyperaldosteronism and hypercortisolism. Adrenalectomy was performed and histopathology was consistent with an adrenocortical tumour. Clinical signs and hormone elevations resolved postoperatively. Relevance and novel information To our knowledge, this is the second report of gynaecomastia secondary to an adrenal tumour in a male neutered cat and the first associated with hyperprogesteronism.

Hyperprogesteronism associated with adrenocortical tumours in two dogs

“…In cats, secretion of progesterone by adrenocortical tumours has been reported in several case reports and case series 20,24–26 . Although they were usually associated to hyperaldosteronism, in a few cases only progesterone secretion was demonstrated 24,25 .…”

“…In cats, secretion of progesterone by adrenocortical tumours has been reported in several case reports and case series. 20,[24][25][26] Although they were usually associated to hyperaldosteronism, in a few cases only progesterone secretion was demonstrated. 24,25 Clinical signs including polyuria, polydipsia, alopecia and diabetes mellitus that would be expected in hyperadrenocorticism were reported in most cases.…”

Surgical findings and outcomes after unilateral adrenalectomy for primary hyperaldosteronism in cats: a multi-institutional retrospective study

“…19 Multiple corticosteroid abnormalities have recently been described in cats with hyperaldosteronism; 5,7,20 tumours secreting multiple hormones, including cortisol and sex hormones, have been reported. 9,21,22 These cats may experience hypocortisolism after adrenalectomy, which can cause lethargy and require corticosteroid sup plementation. 7 In the present study, endocrine tests to rule out hypercortisolism were not routinely carried out.…”

“…1,2 To our knowledge, a total of 50 feline cases with hyperaldosteronism treated by adrenalectomy have been described in the veterinary literature. [3][4][5][6][7][8][9][10][11] Perioperative mortality after adrenalectomy in cats ranges from 20% to 40%. 4,6,7 The most frequent peri operative complication is moderate/severe haemor rhage.…”

“… 1 , 2 To our knowledge, a total of 50 feline cases with hyperaldosteronism treated by adrenalectomy have been described in the veterinary literature. 3 – 11…”