This 14-year-old FS DLH cat was presented for a yearly clinical examination with mild anorexia. Slight weight loss was noted on physical examination, as well as a palpable abdominal mass. Mildly elevated amylase and mildly elevated free T4 were found on blood chemistry analysis. The hepatic enzymes were normal. Urinalysis was unremarkable.
This 14-year-old FS DLH cat was presented for a yearly clinical examination with mild anorexia. Slight weight loss was noted on physical examination, as well as a palpable abdominal mass. Mildly elevated amylase and mildly elevated free T4 were found on blood chemistry analysis. The hepatic enzymes were normal. Urinalysis was unremarkable.
Case Study
Biliary cyst adenoma with palpable abdominal mass in a 14 year old FS DLH cat
DX
Biliary cystadenoma
Sonographic Differential Diagnosis
A benign or low-grade malignant neoplasm was strongly suspected. Granulomatous disease and nodular regeneration were considered less likely.
Image Interpretation
The sonogram demonstrates a large, well-circumscribed, predominately hyperechoic, centrally heteroechoic mass within the caudal left middle liver lobe. The mass extends medially to the portal hilus and appears to impinge on the portal vein and gallbladder neck. Color-flow Doppler supports normal, unobstructed flow within the portal vein.
Outcome
The mass was surgically removed from the left liver with clean margins. Surgery was the treatment of choice because of the slow-growing and expansive nature of this type of tumor, which does not tend to metastasize. It was essential to define the portal hilus in this case to define the resectability of the mass. Even though the mass was of considerable size, the portal hilus was impinged on, but not invaded, and enough right liver was available to the patient to continue to maintain metabolic needs. The US-guided biopsy defined the mass as a slowly growing cystadenoma that rendered surgery the correct method of therapy with a good prognosis. However, given the solitary nature of the lesion, direct biopsy after surgical resection would have been a viable option as well. The patient was lost to follow up.
Comments
No video is available on this patient.
Clinical Differential Diagnosis
Hyperthyroidism with possibilities of underlying pancreatitis, IBD, neoplasia, trichobezoar accumulation, maldigestion.
Sampling
18-gauge US-guided biopsy revealed biliary cystadenoma.
Patient Information
Patient Name :
Topaz S
Gender :
Female, Spayed
Species :
Feline
Type of Imaging : Ultrasound
Status :
Complete
Liz Wuz Here :
Yes
Code :
03_00092
Clinical Signs
- Anorexia
History
- Anorexia
Exam Finding
- Palpable mass
- Weight loss
Images
Blood Chemistry
- Amylase, High
- Hyperthyroidism
Clinical Signs
- Anorexia