9 yo F/S Pittbull, straining to urinate, no improvement with AB. No blood.
Bloodwork and u/a pending.
Hyperechoic 2.5cm mass effect in the trigone and proximal urethra. No blood flow, not shadowing. It almost looks like it’s just in the lumen and not really attached to the ventral wall. What do you think?
I couldn’t see the ureteral papillae.
TCC? polyp? blood clot?
Remaining of scan NSF. Normal med iliac LN, no dilated ureters, no pyelectasia.
Recommended BRAF cadet test and NSAIDS.
9 yo F/S Pittbull, straining to urinate, no improvement with AB. No blood.
Bloodwork and u/a pending.
Hyperechoic 2.5cm mass effect in the trigone and proximal urethra. No blood flow, not shadowing. It almost looks like it’s just in the lumen and not really attached to the ventral wall. What do you think?
I couldn’t see the ureteral papillae.
TCC? polyp? blood clot?
Remaining of scan NSF. Normal med iliac LN, no dilated ureters, no pyelectasia.
Recommended BRAF cadet test and NSAIDS.
Thanks!
Julie
Comments
Looks like a mass to me but
Looks like a mass to me but images are a bit dark and CF is weak. Need to turn up the gain on the CF and close down the sector and may get color. Scope or if you can catheterize her then do an us guided catheterization but until you have confirmation keep organized clot as a potential as clot clogs can cause those clinical signs like after moving a stone or during coagulopathy. Rescan in a few days and see if it dissappears. Im personally not a big BRAF test fan as I have seen false + and false – so I wouldnt be definitive cancer dx based on that test but nice screening to see if an ultrasound is needed :). Tissue is the key here as always. Scope ideally and laser ablation +/- u stent where available if + tcc mass confirmed.
Hi Eric,
Thanks for your
Hi Eric,
Thanks for your input. Yes, it was dark… no sedation, super wiggly overweight patient, I moved fast. I realized it after the exam. The images with the linear are lighter, but I didn’t get much more details. Didnt think about increasing the gain and closing down the sector for the CF. Thanks! Next time I will.
We have a referral clinic in DC that does the cytoscopic biopsy and laser debulking, so that’s nice.
Good to know on the BRAF.
julie
Best way to diagnose bladder
Best way to diagnose bladder tumours is via catheter-assisted biopsy technique if cystoscopy is unavailable. Athough BRAF test is recommended as Eric states can get false -ve and false + results. In fact urine sediment cytology is probably better than the BRAF test.
Thank you Dr. Lobetti! I will
Thank you Dr. Lobetti! I will mention the false – and + when I recommend the BRAF test. We have cytoscopy access at a practice near by, which is very nice! I will update the post once we know more.
Update. BRAF test was a false
Update. BRAF test was a false negative. Biopsy by cytoscopy confirmed TCC. She is doing well on NSAIDS and Leukoran.
Great thanks for the
Great thanks for the follow-up