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Possible uterine stump pyo or neoplasia in an 8 year old Dachshund

Sonopath Forum

Sonopath Forum

Possible uterine stump pyo or neoplasia in an 8 year old Dachshund

  • 8 year old FS Dachshund presented for 2 month history of ADR, one episode of vaginal discharge, and more recently pollakiuira.  Cysto urinalyis showed hematuria.  Urine culture was negative.  CBC and chem prof were wnl.  USG was >1.040.
  • Abominal ultrasound shows a 3.0 x 4.0cm complex mass dorsal to the bladder trigone and urethra and ventral to the colon.  In some views there is a shadowing echogenic center representing either a gas filled lumen or mineralization.  Transverse views place this mass on the left side of the bladder.

    • 8 year old FS Dachshund presented for 2 month history of ADR, one episode of vaginal discharge, and more recently pollakiuira.  Cysto urinalyis showed hematuria.  Urine culture was negative.  CBC and chem prof were wnl.  USG was >1.040.
    • Abominal ultrasound shows a 3.0 x 4.0cm complex mass dorsal to the bladder trigone and urethra and ventral to the colon.  In some views there is a shadowing echogenic center representing either a gas filled lumen or mineralization.  Transverse views place this mass on the left side of the bladder.
    • My primary differentials are uterine horn remnant-granuloma-pyo or neoplasia of the uterine stump.  In house FNA showed multiple rbc’s, PMN’s, a few macrophages, and a few dividing round epithelial cells with no suggestive signs of neoplasia (normal nucleus and nuclear to cytoplasm ratio, etc.).  Out lab cytology is pending.
    • I am just wondering what else could be in this area (make sure I am not missing anything).  The mass overlaps with the region of the left distal ureter, but there is no evidence of any ureteral obstruction.  The left kidney appears normal in size, no pyelectasia or inflammation, kidney function is normal, there is no azotemia.  I am also thinking that on the sagittal view, the tubular portion of the mass is a bit caudal for ureter.
    • What do you docs think?

Comments

Pankatz
October 13, 2016 at 11:29 am -

Hi Melissa
I vote for stump

Hi Melissa

I vote for stump pyometra. Did you look for an ovarian remnant? Not easy to see I know.

Jacquie

Electrocute
October 13, 2016 at 12:57 pm -

Excellent thought.   I did

Excellent thought.   I did not see one but will tell them to look at surgery.  Thanks Jacquie!  

EL
October 14, 2016 at 1:33 pm -

yes definitely stump pyo and

yes definitely stump pyo and that hyperechoic area in the center is likely the residual suture material. Regional peritonitis too. leiomosarcoma can do this as well underneath the stump pyo so needs sx culture and bx. Its going to be a bit messy in there.

 

Electrocute
October 17, 2016 at 11:22 pm -

Thanks Eric.  Client decided

Thanks Eric.  Client decided to go to a referral clinic for surgery.  Will hopefully have an update by the end of the week.

 

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