Case Of the Month

Defining Surgical Resectability of a Bladder Mass in a 13-year-old FS Pointer Mix: Our Case Of the Month December 2018

The patient was presented due to panting, urinary accidents, PU/PD, +1 polyphagia, hepatomegaly on radiographs. Urinalysis revealed hematuria, pyuria, and hyposthenuria. U/A: USG 1.002, protein +2, WBCs 4-10, RBCs 11-20, rods 26-50. Blood chemistry results: ALT 283, Alk. Phos. 226.

DX

Bladder mass. Left-sided liver masses.

Outcome

CT evaluation is warranted for surgical planning. The bladder mass appears resectable with resection at
the ventral wall. The liver mass may be resectable as well; however, CT evaluation would be best for
surgical planning. The spleen appears subjectively benign. These are likely two separate issues likely
carcinoma of the bladder and likely hepatocellular carcinoma of the liver.

Comments

The owners declined any further diagnostics and have opted to keep the dog comfortable for as long as possible.

Oncology consultations for cases like these can be utilized through Sonopath.com. You can select the oncology drop down at http://spa.sonopath.com/.

Image Interpretation

Urinary bladder: revealed a ventral bladder mass that measured 3.0 x 2.5 cm. The mass was deriving from the ventral wall and extended caudally along the ventral wall to approximately 1.0 cm from the cystourethral junction. This allowed for resection. A minimal amount of urine was present and impinged upon the dorsal wall. The mass was particularly vascular. This is typical for transitional cell carcinoma. This is potentially resectable. However, local metastasis to the dorsal wall with a kissing lesion cannot be entirely ruled out as a minimal amount of urine was present at the time of the sonogram. Cystourethral junction and urethra appeared unremarkable. The pelvic urethra was imaged 4.0 cm beyond the cystourethral junction.

Liver: presented multiple masses, which is likely independent from the bladder mass and impinged upon the portal hilus and gallbladder. Subtle, heterogenous right-sided changes were noted. CT evaluation is warranted for surgical planning.