Case Study

Benign splenic mass in a 10 year old FS Saint Bernard

The patient is a 10 year old FS Saint Bernard canine. The patient presented for an annual exam but a mass was palpated in abdomen. The owner noted that the patient may be slightly lethargic but it was difficult to tell if this was an aging change. Otherwise the physical exam was within normal limits. CBC/Chem/UA values were all normal.

The patient is a 10 year old FS Saint Bernard canine. The patient presented for an annual exam but a mass was palpated in abdomen. The owner noted that the patient may be slightly lethargic but it was difficult to tell if this was an aging change. Otherwise the physical exam was within normal limits. CBC/Chem/UA values were all normal.

Sonographic Differential Diagnosis

Benign (hematoma or chronic fibrosing splenic disease) or malignant (sarcoma or malignant histiocytosis) splenic mass. No evidence of thoracic or hepatic metastasis. A splenectomy would be recommended if chest radiographs are unremarkable.

Image Interpretation

The spleen in this patient presented a 10 cm mass that was deriving from the caudal pole with focal, hyperechoic areas with mixed, micronodular changes. There was no evidence of rupture of the spleen at this time and no significant cavitation was noted. Cursory evaluation of the heart revealed a normal right auricle without evidence of pericardial effusion.

DX

Benign splenic mass

Outcome

One year later, the only abnormalities on ultrasound were of the urinary bladder.

Comments

Studies have shown that 40-50% of solitary splenic masses in dogs are benign. This case demonstrates the need to allow benefit of the doubt to the patient even if the mass is ominous and on ultrasound resembles a neoplastic process such as hemangiosarcoma.