Case of the week 8.20.18
Publication Date: 2018-08-20
History
10 year old border collie. Chronic regurgitation for a month.
5 images
Findings
Orthogonal radiographs of the abdomen are available for interpretation.
Occupying the right cranial mid abdomen, there is a very large bilobed mass with a mostly gas filled lumen and thick soft tissue opaque wall (up to approximately 3.0cm thick) which is approximately 18.0 cm in length and 9.0 cm in diameter. The outer wall of this mass is smoothly marginated and its inner wall is undulating. Within its mostly gas filled lumen, there is a small amount of heterogenous foamy soft tissue opaque material. The mass is resulting in caudodorsal and leftward displacement of the majority of the small intestines.
There is focal decreased serosal detail at the ventral aspect of this mass. The stomach is empty. The duodenum can be seen and courses parallel to and to the right of the mass.
The displaced small intestines are normal in diameter and contain mostly gas. Only the mid and caudal descending colon can be identified and is within normal limits.
The liver, spleen, unobscured kidneys and urinary bladder are normal. The included thoracic and musculoskeletal structures are normal.
Diagnosis
The large cavitary mass within the right cranial mid abdomen is compatible with an intestinal neoplasia, most likely originating from the cecum; differentials include adenocarcinoma, lymphoma, gastrointestinal stromal tumor or leiomyosarcoma. A second less likely differential is abscessation of the cecum. Focal peritonitis.
Discussion
An abdominal ultrasound and fine needle aspirates were performed.
The abdominal ultrasound was most suggestive of primary neoplasia arising from the small intestines with areas of edema.
Cytology results indicated that the mass was most likely neoplastic but the cell type could not be determined.
The patient underwent surgery and an intestinal stromal tumor was removed based on histopathology results.
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