Case Study

03_00433 Liberty C Mixed echoic liver masses

A 7-year-old SF Shepherd mix was presented for evaluation of lethargy, ataxia, vomiting, and progressive elevation in liver enzyme activity. Abnormalities on CBC and serum biochemistry were neutrophilia and elevated liver enzyme activity. Survey radiographs showed a mass effect.

Sonographic Differential Diagnosis

Medial liver masses, complex. Likely hepatocellular carcinoma. The mass is non-resectable. Fine needle aspirates warranted for further definition; however prognosis is poor.

Image Interpretation

Liver in this patient presented mildly complex mass deviating the diaphragm. The liver mass occupied most of the deep right liver; is not resectable measuring 9.2 x 8.2 cm with impingement upon the diaphragm and probable adherence. Free fluid was noted adjacent to the liver lobes owing to either hemorrhage or portal hypertension. The portal vein was deviated and enveloped by the liver mass. Portal vein branches were deviated within the liver itself. Gallbladder was enveloped by the mass as well.