Sonopath Forum

Very arge lipoma -like mass and 2 smaller complex masses in a 11 yr old Coon Hound

11 yr old mc Coon Hound presented for abdominal distention one year ago, diagnosed with ascites based upon radiographs, but declined abdominal US at that time.
Dog presents again today one year later, still asymptomatic, but with severe abdominal distension.
Bloodwork is wnl except for ALP=379 U/L. Rads show craniolateral displacement of the intestines and possible ascites.

11 yr old mc Coon Hound presented for abdominal distention one year ago, diagnosed with ascites based upon radiographs, but declined abdominal US at that time.
Dog presents again today one year later, still asymptomatic, but with severe abdominal distension.
Bloodwork is wnl except for ALP=379 U/L. Rads show craniolateral displacement of the intestines and possible ascites.
Abdominal ultrasound shows no ascites. However, there is a very large intra-abdominal mass extending from just caudal to the liver to just cranial to the bladder. It is causing lateral dorsal displacement of the spleen, kidneys, and intestines. It has the sonographic appearance of a lipoma (see the first image).
There are also two complex masses in the midabdomen. The 7.0cm complex mass on the right side of the abdomen shows mixed echogenicity and the echogenic portions show accoustic shadowing suggestive of fibrosis, mineralization, or gas (see video clip). It has adjacent, echogenic fat.
The midabdominal mass on the left is also of mixed echogenicity with no shadowing. It is well encapsulated and is in contact the large lipoma like mass (see image 2).
FNA’s are pending but I did not see any neoplastic cells on in-house review of the slides.
I truly believe the largest mass to be a lipoma or liposarcoma, but am unsure about the complex masses. My differential diagnoses include necrotic lipomas or necrotic extensions of the largest mass, granulomas, abscesses, or GI tumor (GIST, leioma, leiomyoma, leiomyosarcoma) and much less likely neoplastic lymph nodes.
Would like to get other thoughts on this complex masses. Again, the dog is asymptomatic but his abdomen is so distended ventrally and laterally from the largest mass I suspect he must be in some discomfort.