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Liver lesion, history of osteosarcoma

Sonopath Forum

Liver lesion, history of osteosarcoma

13y FS Lab w/ forelimb amputation due to osteosarcoma 3 months ago.  Not clinical.  Owner is a do everything client.  Met check is WNL.  Would like to FNA this solitary lesion in the liver, but seeing a decent amount of flow on both color and power doppler.  This dog has consistently had an ALP >1000.  ALT has been normal, but is now just below 200.  Rest of abdominal ultrasound was WNL.  Thoughts?

13y FS Lab w/ forelimb amputation due to osteosarcoma 3 months ago.  Not clinical.  Owner is a do everything client.  Met check is WNL.  Would like to FNA this solitary lesion in the liver, but seeing a decent amount of flow on both color and power doppler.  This dog has consistently had an ALP >1000.  ALT has been normal, but is now just below 200.  Rest of abdominal ultrasound was WNL.  Thoughts?

Comments

rlobetti

May be an unrelated mass –

May be an unrelated mass – nodular regeneration, granuloma, early hepatoma, or primary malignat hepatic neoplasia. With the history and elevated liver enzymes, FNA is indicated and even possibly a biopsy.

EL

Yes I agree with remo surely

Yes I agree with remo surely needs a needle and may be unrelated. Osteosarc mets tend to start to mineralize so when you look at it again this may have changed echotexture and run the linear probe on this liver as well to look for sutble other nodules as mets usually bring friends.

You are getting color splash here from respiratory movement and not true flow. I would sedate run the linear, try power doppler at that point then fna both the transition from normal to abnormal as well as down the center but surely needs a needle.

kromero

Thank you for the feedback –

Thank you for the feedback – especially re color splash.  We are proceding tomorrow and she will be sedated.