Case Study

Infiltrative mass within the ileocecal junction and ileum in a 6 year old FS Boxer

A 6-year-old FS Boxer was presented for evaluation of a 2-week duraton of progressive inappetence to complete anorexia, weight loss, vomiting and diarrhea. Hypoproteinemia was presented on serum biochemistry and survey radiographs showed a suspicious region of intestinal thickening and gas pocketing.

DX

Ileocecal infiltrative pattern. Regional lymphadenopathy

Image Interpretation

The ileocecal region in this patient revealed an infiltrative mass within the ileum. The mass measured 2.0 cm x an extension of at least 4.0 cm. Fluid accumulation was noted in the cecum. Minor regional inflammatory pattern was noted around the jejunal serosa. The remainder of the gastrointestinal tract appeared unremarkable. Slight, regional lymph nodes were enlarged and measured 1.5 cm. Reactive fat was noted in the ileocecal region.

Outcome

Two separate approaches could be considered in this patient: An aggressive, ileocecocolic resection and lymph node biopsy or ultrasound-guided FNA of the portion of infiltrated intestine and regional lymph node. Focal lymphoma, mast cell disease and carcinoma are the primary differentials. Complicated inflammatory bowel and intestinal necrosis is also possible, yet less likely. Guarded prognosis. There was no overt evidence of organ metastasis noted; however, regional lymph node metastasis is strongly possible.