- 12 year old WHWT with vomiting, decreased appetite and off form, history of pancreatitis
- Confirmed pancreatitis on scan but also a large cystic liver mass and irregular thickened apical bladder wall (suspect TCC?). The SL and mesenteric LNs appear to be enlarged also
- Is this likely to be a malignant liver mass? It encompassed all right side of liver, can you confirm lobes from scan and if it would be resectable?
- May just help with case management…
- 12 year old WHWT with vomiting, decreased appetite and off form, history of pancreatitis
- Confirmed pancreatitis on scan but also a large cystic liver mass and irregular thickened apical bladder wall (suspect TCC?). The SL and mesenteric LNs appear to be enlarged also
- Is this likely to be a malignant liver mass? It encompassed all right side of liver, can you confirm lobes from scan and if it would be resectable?
- May just help with case management…
Comments
The mass in the urinary
The mass in the urinary bladder looks like chronic cistitis pattern, but without histology it’s just a guess (I’m not sure about the d-pap there, it seems a little bit dilated). Have you tried traumatic catheterization? It could work well on this case.
I think the hepatic mass has potential to be resected, but I wouldn’t try it without a biopsy. It could be a biliary benign cystadenoma, or cystoadenocarcinoma. Look at this cool case just like yours – https://sci-hub.se/10.1292/jvms.11-0197 – old age dog with previously diagnosed with pancreatitis and with cystadenoma incidental finding (diagnosed by histology upon resection).
The jejunal LNs seem reactive to me as well.
The position of the bladder
The position of the bladder mass is cystitis more likely but TCC does grow there and the mural mineralization and irregular polypoid stalk and transmural pattern fits more tcc for me. Looks like it gets into the muscularis there at points.
The right cranial liver mass tough to resect there but im not a surgeon and surgical abilities vary greatly on liver tumors between vets wiht a scalpel. I’m comncerned for the adherence to the diaphragm as well and the right branch of the pv and hepatic veins may be in there as well. I defer to CT with contrast and let the surgeons decide if they want to attack it. Low grade HCC would be my guess given the architecture but yes right IC position 12-13 sdep, 25 g fna is what I would do here ot put a name on it and stay in the transition zones normal to abnormal architecture.
Any evidence of UTI as can
Any evidence of UTI as can result in irregular wall thickening. However, with the agre would be concerned about neoplasia. As Eric suggests ideal candidate for a catheter-assissted biopsy.
It was an incidental finding.
It was an incidental finding. I will let you know if owners decide on biopsies. Thanks for the advice.