- 10 year old FS West Highland Terrier with chronic progressive vomiting and hemoptysis.
- Radiographs showed a possible mass or filling defect in the gastic body
- Abdominal ultrasound shows a 3.46cm (l) x 2.25cm (d) hypoechoic mass originating from the dorsal gastric wall and projecting into the gastic lumen (fundus).
- I had to place the patient in a standing position and administer water PO in order to visualize and confirm the presence of this mass. I cannot aspirate as no window without going through the stomach lumen.
- 10 year old FS West Highland Terrier with chronic progressive vomiting and hemoptysis.
- Radiographs showed a possible mass or filling defect in the gastic body
- Abdominal ultrasound shows a 3.46cm (l) x 2.25cm (d) hypoechoic mass originating from the dorsal gastric wall and projecting into the gastic lumen (fundus).
- I had to place the patient in a standing position and administer water PO in order to visualize and confirm the presence of this mass. I cannot aspirate as no window without going through the stomach lumen.
- My primary rule outs are neoplasia (adenocarcinoma, lymphoma, less likely leiomyoma or leiomyoscarcoma, extramedullary plasmacytoma), and much less likely benign tumor. I have recommended endoscopy or surgery with biopsy next.
- What are your primary differentials? Would this be resectable? Also, does the echogenic line along the lumenal/mucosal surface of the mass indicate ulceration?
Comments
Spot on with your
Spot on with your differential diagnoses. Would add fungal granuloma to the list. From the ultrasound mass appears to be ulcerated but is potentially resectable but would do 3-view thoracic radiographs to r/o pulmonary mets first.
Thank you Dr. Lobetti!
Thank you Dr. Lobetti!
I would power doppler this
I would power doppler this and use lower frequency to ensure its not a fb acting like a mass and localize it for potential resection. If in the pylorus then billroth sx necessary
It is not in the pylorus. It
It is not in the pylorus. It remains on the dorsal surface when I flip the dog over. I could not use Doppler due to the patient’s excessive panting (he was sedated but still agitated) but yes, that would have been nice. When I scroll through my videos in slow motion, it really appears to me that the mass is orignating from the dorsal wall and not just sitting on it. I suppose foreign body granuloma is a possiblity, however, did not see a classic FB.