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Case Report: Multimodal Imaging Features of Pedunculated Liver Masses in Seven Dogs.

ABSTRACT: This study describes the multimodal imaging characteristics of pedunculated liver masses in seven dogs [Cocker Spaniel (n = 2), Maltese (n = 1), Shih-Tzu (n = 2), and Schnauzer (n = 2)]. These masses are anatomic variants of hepatic masses in which the center of the mass lies outside the liver contour. Prior to referral, only one dog had been diagnosed with a hepatic mass, four had been diagnosed with mid-abdominal masses of unknown origin, and two had been misdiagnosed with splenic head and pancreatic masses. Using radiographs, the mass locations were classified as cranioventral (n = 3), mid-abdominal (n = 2), or craniodorsal (n = 2). The gastric axis was deviated in various directions in four cases. Based on computed tomography (CT) findings, the masses were noted to originate from every liver lobe (two from the left lateral lobe) and to possess parenchymal (n = 6) or vascular (n = 1) pedicles. The histopathological results showed that three masses were benign [hepatic adenoma (n = 1) and nodular hyperplasia (n = 2)] and four were malignant [hepatocellular carcinoma (n = 3) and cholangiocarcinoma (n = 1)]. For three dogs, triple-phase CT maximum intensity projection images in the arterial phase clearly showed that the masses were connected to the hepatic artery. We propose that a pedunculated liver mass should be considered as a differential diagnosis when a mass is located in the mid-abdomen, even if it is separated from the liver and with the gastric axis deviated in various directions. We consider CT imaging to be a useful tool for diagnosis, evaluation, and surgical planning in dogs with a pedunculated liver mass.

SUBMITTER: Ko J

PROVIDER: S-EPMC7732477 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Case Report: Multimodal Imaging Features of Pedunculated Liver Masses in Seven Dogs.

Ko Jaeeun J Hwang Jeongyeon J Yoon Hakyoung H Eom Kidong K Kim Jaehwan J

Frontiers in veterinary science 20201124

This study describes the multimodal imaging characteristics of pedunculated liver masses in seven dogs [Cocker Spaniel (n = 2), Maltese (n = 1), Shih-Tzu (n = 2), and Schnauzer (n = 2)]. These masses are anatomic variants of hepatic masses in which the center of the mass lies outside the liver contour. Prior to referral, only one dog had been diagnosed with a hepatic mass, four had been diagnosed with mid-abdominal masses of unknown origin, and two had been misdiagnos ...[more]

PMID: 33330705

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Project description:BackgroundParaganglioma occurs rarely in the sellar/parasellar region. Here, we report a patient with malignant paraganglioma with primary sellar location with unusual genetic and imaging features.Case presentationA 31-year-old male presented with mild hypertension, headache, nausea, and vomiting. A sellar/parasellar tumor mass was revealed by magnetic resonance imaging (MRI), while an endocrine work-up found partial hypopituitarism, suggesting that it was a non-functioning pituitary tumor. Antihypertensive therapy and hormone replacement were initiated. Tumor reduction was achieved with transsphenoidal neurosurgery. However, histological diagnosis was not possible due to extensive tissue necrosis. After 4 years of stable disease, the residual tumor showed re-growth requiring gamma knife radiosurgery. Four years after the radiosurgery, MRI showed a significant tumor progression leading to a second neurosurgery. This time, pathological and immunohistochemical findings revealed paraganglioma. Plasma levels of metanephrine and normetanephrine were normal. A gene sequencing panel performed on DNA extracted from blood excluded germline mutations in 17 susceptibility genes. The patient developed new tumor masses in the neck, and the third surgery was performed. Immunohistochemistry demonstrated lack of ATRX (alpha thalassemia/mental retardation syndrome X-linked) protein in tumor cells, indicating an ATRX gene mutation. Molecular genetic analysis performed on tumor DNA revealed a combination of ATRX and TP53 gene abnormalities; this was not previously reported in paraganglioma. MRI and 68Ga-DOTANOC PET/CT revealed the full extent of the disease. Therapy with somatostatin LAR and 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) was initiated.ConclusionAlthough rare, paraganglioma should be considered in the differential diagnosis of sellar/parasellar tumor lesions, even in the absence of typical imaging features. ATRX gene mutation in paraganglioma is an early predictor of malignant behavior and a potential novel therapeutic marker when pharmacological therapy targeting mutated ATRX becomes available.

Dataset Information

Case Report: Multimodal Imaging Features of Pedunculated Liver Masses in Seven Dogs.

Publications

Case Report: Multimodal Imaging Features of Pedunculated Liver Masses in Seven Dogs.

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