Case of the week 3.22.21
Publication Date: 2021-03-22
History
12 year old male castrated mixed breed dog. Weak. Vomited twice
6 images
Findings
Opposite lateral and VD radiographs of the abdomen are available for interpretation.
The serosal detail is within normal limits. There is fluid streaking within the retroperitoneal space.
The margins of the left kidney are effaced by a large homogeneously soft tissue opaque mass, measuring about 11.6cm diameter.
The right kidney is obscured by superimposed GI tract on all views.
The stomach and small intestines contain a small amount of heterogeneous soft tissue opaque ingesta and gas and are normal in size. Two small mineral opaque foci are present in the stomach, suggestive of rocks and incidental. There is a large amount of formed stool within the colon, which is normal in size. The small intestines are grouped ventrally and toward the right side. The liver and spleen are normal
Bridging spondylosis is seen between L1-L2.
There are numerous small soft tissue opaque pulmonary nodules throughout the lung lobes
Discussion
Left renal mass and pulmonary nodules are most consistent with a left renal neoplasia (such as carcinoma) and pulmonary metastasis. Mild retroperitoneal effusion may represent associated hemorrhage or urine leakage.
Notes
The patient underwent a full abdominal ultrasound and FNAs of the left renal mass. The FNAs were consistent with neoplasia but a specific diagnosis could not be made. Considerations included carcinoma vs sarcoma. Based on the poor prognosis due to the presence of metastatic disease the patient was euthanized at the owners' request.
Addendum
The patient was initially seen by Dr. Fazio