Case Study

Splenic mass in a 14 year old MN Shepherd mix

A 14-year-old MN Shepherd mix was presented for a routine vaccination with a history of diarrhea that had been treated with metronidazole. On physical examination the body condition was II/V and a round, smooth mid abdominal mass was palpated. CBC was within normal limits; serum biochemistry revealed elevated ALT, ALP, and BUN. Survey radiographs showed a mass effect in the mid ventral abdomen.

DX

Solitary splenic mass. Moderate age related renal and hepatic changes.

Sonographic Differential Diagnosis

Solitary splenic mass indicative of round cell neoplasia, hemangiosarcoma, or hemangioma. Moderate age related renal and hepatic changes. There was no evidence of right auricular metastatic lesions.

Image Interpretation

The spleen presented a solitary parenchymal mass that measured 4.5 x 2.5 cm with capsular expansion. This is most consistent with low grade neoplasia such as round cell neoplasia. Hemangiosarcoma is also possible given the breed. However, there was no evidence of rupture was noted. This appears resectable. Rapid assessment of the right auricle appeared normal.

Outcome

The patient was started on Dexamethasone SP injections and the owner was going to think about options. The patient improved clinically, but the owner decided against pursuing a splenectomy due to liver values.

Comments

The patient was humanely euthanized after a decline in quality of life.

Clinical Differential Diagnosis

Abdominal mass – neoplasia, granuloma, abscess, cyst (originating in the spleen, liver, kidney, pancreas, or lymph nodes), hydronephrosis, or splenic torsion. Liver disease – vacuolar hepatopathy, chronic active hepatitis, infection (bacteria/viral), toxic, metastatic neoplasia.