- 12 year old Rhodesian Ridgeback presented for solitary episode of bilateral rear leg ataxia. When the owners woke up in the am, the dog was ataxic in the rear legs but this resolved in the same day.
- This dog was tx for stage 1 HW dz in 2009. This dog also has epilepsy, so this could have been post-ictal with no one awake to observe the seizure.
- BP measurements were normal. PCV/TP platelet count was normal. Chem profile showed elevated liver enzymes.
- 12 year old Rhodesian Ridgeback presented for solitary episode of bilateral rear leg ataxia. When the owners woke up in the am, the dog was ataxic in the rear legs but this resolved in the same day.
- This dog was tx for stage 1 HW dz in 2009. This dog also has epilepsy, so this could have been post-ictal with no one awake to observe the seizure.
- BP measurements were normal. PCV/TP platelet count was normal. Chem profile showed elevated liver enzymes.
- Echo was normal except for a slightly increased LVIDd, however, cardiac contractility was excellent. Abdominal ultrasound showed a large (12.0cm), multi-cystic hepatic mass with high vascularity seen on color flow Doppler. I do not think that it is resectable. My primary differentials are HSA and hepatic carcinoma.
- Cytology performed on FNA of liver came back as hepatic tissue showing a multifocal fatty infiltration most consistent with benign nodular regeneration/hyperplasia.
- I know that benign nodular hyperplasia can look like anything, but can it really be cystic? I could go back and do core biopsies, but am a little bit concerned about being able to avoid the cysts.
Comments
To me this looks like a very
To me this looks like a very large cystadenoma or outside chance of adenocarcinoma. I think a diagnosis will require a core biopsy.
As per Randy core biopsy
As per Randy core biopsy would be ideal. Can try repeating FNA from different areas of the mass and from its periphery.
Thanks for your input. I
Thanks for your input. I have offered a core bx although going in between the cysts will be interesting. I am also waiting to hear back from the cytologist.
Use a trajectory that is part
Use a trajectory that is part normal liver part parechnyma of the mass with minimal cysts. The cysts are usually filled with transudate and usually not a big deal but put power doppler over the region first to avoid blood vessels. Biliary carcinoma likely, HCC possible both wil fna wiht those results.
Thanks Eric. Will let you
Thanks Eric. Will let you all know results if I get the opportunity to do core bx’s. I think the ataxia was just post-ictal and this was just a chance finding in an otherwise asymptomatic patient.