Case Study

CT – Non resectable liver mass, likely hepatocellular carcinoma, in a 14 year old FS Rat Terrier

This 14 year old FS Rat Terrier dog presented for a palpable liver mass, confirmed with ultrasound. CT to determine if resectable.

DX

The computed tomography of the abdomen shows a large liver mass emerging from the right medial and quadrate lobes meeting neoplastic criteria.

Image Interpretation

CT of the abdomen –

The computed tomography reveals a highly vascularized, large right-sided hypoattenuating liver mass measuring more than 10 cm in diameter. The mass emerges from the right medial liver lobe and involves the quadrate liver lobe entrapping the portal hilus with the cystic and common bile duct. Large tumor vessels can be traced from the central branch of the portal vein and the hepatic vein. The mass exerts a significant mass effect on the surrounding anatomy including the stomach, pancreas and transverse colon.

There is no evidence of intraabdominal metastatic spread. There is no peritoneal effusion.

Both renal cortices reveal multiple small non-enhancing cystic lesions.

Outcome

The findings are suggestive for a hepatocellular carcinoma. Possible differential diagnoses include a hemangiosarcoma, hepatoma or other neoplasia.
The mass lesion is in close proximity and exerts a significant mass effect on critical vascular and biliary anatomy. The position of the mass is unfavorable for tumor resection. The prognosis for tumor resectability is guarded.
In case a surgical exploration is strived regardless tumor staging should be complemented by 3 view chest radiograph