Ectopic hepatocellular carcinoma in a dog

CASE HISTORY: A 14-year-old neutered male Bearded Collie was presented with a history of recurrent, intermittent urinary incontinence of 7 years duration. CLINICAL FINDINGS: A large, firm, non-painful mass was found in the mid-abdominal region on palpation. Ultrasonography of the mass revealed a compartmentalised structure with mixed echogenicity, and which did not appear to be associated with any of the abdominal organs. Ultrasound-guided fine needle aspirates contained several clusters of epithelial cells with cytological features of hepatocytes. At exploratory laparotomy, the mass was found in the gastrosplenic ligament within the greater omentum. PATHOLOGICAL FINDINGS AND DIAGNOSIS: Histopathologically, the mass consisted of sheets of hepatocytes, but without the characteristic hepatic architecture. The cells showed moderate variation in nuclear size and were sometimes binucleate. A diagnosis of hepatocellular carcinoma (HCC) in the mesentery was made. CLINICAL RELEVANCE: The presence of ectopic hepatic tissue has been reported rarely in man and cats, but not in the dog. Neoplastic transformation of ectopic hepatic tissue is seen in man. This is the first report of the presentation, clinical findings and treatment of a dog with ectopic HCC.     

Ectopic hepatocellular carcinoma in a dog

CASE HISTORY: A 14-year-old neutered male Bearded Collie was presented with a history of recurrent, intermittent urinary incontinence of 7 years duration.

CLINICAL FINDINGS: A large, firm, non-painful mass was found in the mid-abdominal region on palpation. Ultrasonography of the mass revealed a compartmentalised structure with mixed echogenicity, and which did not appear to be associated with any of the abdominal organs. Ultrasound-guided fine needle aspirates contained several clusters of epithelial cells with cytological features of hepatocytes. At exploratory laparotomy, the mass was found in the gastrosplenic ligament within the greater omentum.

PATHOLOGICAL FINDINGS AND DIAGNOSIS: Histopathologically, the mass consisted of sheets of hepatocytes, but without the characteristic hepatic architecture. The cells showed moderate variation in nuclear size and were sometimes binucle- ate. A diagnosis of hepatocellular carcinoma (HCC) in the mesentery was made.

CLINICAL RELEVANCE: The presence of ectopic hepatic tissue has been reported rarely in man and cats, but not in the dog. Neoplastic transformation of ectopic hepatic tissue is seen in man. This is the first report of the presentation, clinical findings and treatment of a dog with ectopic HCC.     

Acquired myasthenia gravis associated with a non-invasive thymic carcinoma in a dog

An 8 1/2-year-old neutered male Beagle was diagnosed with acquired myasthenia gravis associated with a non-invasive thymic carcinoma. The thymic mass was surgically excised and the dog was treated with pyridostigmine, prednisolone and azathioprine. Serial acetylcholine receptor antibody titres were increased initially but slowly declined to normal values over a period of 24 weeks. Improved exercise tolerance was seen following therapy, however, oesophageal dysfunction persisted. The dog was euthanased 26 weeks after initial presentation due to a complicating illness. A necropsy showed no regrowth or metastasis of the thymic carcinoma.     

Transformation of a thymic branchial cyst to a carcinoma with pulmonary metastasis in a dog

A 9-year-old, female neutered Dalmatian was evaluated for acute onset of dyspnoea. Thoracocentesis on presentation yielded 1300 ml sanguineous fluid, while thoracic radiology and ultrasonography showed a mixed-echoic cavitary cranial mediastinal mass, sternal lymph node enlargement and pleural effusion. Surgical exploration of the thorax revealed a multi-lobulated red/brown cranial mediastinal mass and multiple similarly coloured ovoid nodules within several lung lobes. Histopathology revealed thymic branchial cysts with neoplastic transformation and examination of the lung was consistent with metastasis. Despite initially recovering well, acute sepsis and pyothorax resulted in cardiac arrest 8 days postoperatively. This is the first veterinary report of neoplastic transformation of a thymic branchial cyst with pulmonary metastasis.     

Ectopic thyroid carcinoma infiltrating the right atrium of the heart in a dog

A 12-year-old intact female shih tzu dog was diagnosed with an ectopic thyroid carcinoma infiltrating the right atrium of the heart. Echocardiography and computed tomography were helpful in diagnosis; a definitive diagnosis was made based on postmortem histopathology and immunohistochemistry. The patient lived 428 days beyond diagnosis with only medical management.     

Paratracheal cervical mass in a dog

A 14-year-old female Welsh Terrier was presented for evaluation of multiple skin masses. Two of them were diagnosed as a follicular (epidermal) cyst and a sebaceous epithelioma by cytology and histopathology. The third mass was located in the subcutis adjacent to the cervical trachea. Clinical findings, thoracic radiography, and laboratory results were otherwise unremarkable. Cytologically, the cervical mass was characterized by the presence of round to polygonal cells with distinct cell borders, mild to moderate anisocytosis, round to oval eccentric nuclei with prominent nucleoli, and a variable amount of finely granular, eosinophilic cytoplasm. Differential diagnoses included endocrine/neuroendocrine tumors such as thyroid adenocarcinoma, medullary thyroid carcinoma, carotid body chemodectoma, and parathyroid carcinoma. The mass was removed surgically and submitted for histopathologic and immunohistochemical examination. Histologically, the mass was composed of rows and nests of densely packed cells separated by thin fibrovascular stroma. Neoplastic cells had moderate to large amounts of pale eosinophilic dusty or finely vacuolated cytoplasm and round to oval nuclei with finely dispersed chromatin and 1 or 2 small nucleoli. On immunohistochemistry, neoplastic cells were positive for chromogranin A, calcitonin, and neuron-specific enolase, and were negative for cytokeratin and thyroglobulin. The final diagnosis was medullary thyroid carcinoma, an uncommon endocrine tumor of dogs that has cytologic and histopathologic features similar to other endocrine and neuroendocrine tumors. Immunohistochemistry or immunocytochemistry should be performed to differentiate medullary thyroid carcinoma from other endocrine/neuroendocrine tumors of dogs.     

Metastatic thyroid solid-follicular carcinoma in the cervical portion of the spine of a dog

A metastatic thyroid solid-follicular carcinoma in the cervical portion of the spine was responsible for severe tetraparesis in a dog. Myelography revealed an extradural compressive lesion dorsal and to the right of the midline of C3. Histologic examination was used to diagnose the mass as a solid-follicular thyroid carcinoma. The primary tumor was not evident on cervical palpation or radiography. A dorsal laminectomy centered over C3 was performed, and all visible tumor was removed from the spine. The owner declined any further treatment for the dog.     

Gastric carcinoma in a dog

An 8–year-old castrated male Bassett hound had been vomiting intermittently for 3 weeks. In addition, clinical signs of anorexia, weight loss, dehydration, depression and anterior abdominal pain were noted. Gastro-scopic and radiographic examination revealed a mass at the pyloric region of the stomach. Clinical remission followed surgical excision of gastric carcinoma, with recurrence of vomiting 4 months after surgery. At necropsy, the pyloric region of the stomach was markedly thickened, rigid, scirrhous and had an excavated ulcer. The pathological diagnosis was a poorly differentiated, diffuse gastric carcinoma with metastasis to regional lymph nodes.     

Infiltrative lipoma in cervical bones in a dog

A 4-year-old, neutered male Maltese presented with a 2-month history of right hemiparesis. The radiographic findings revealed bone lysis, and sclerotic changes in the right section of the fifth and sixth cervical bones with a mild radiolucent mass around the lesion. The magnetic resonance imaging revealed a hyperintense mass located in the region extending from the muscles to the bones and compressing the spinal cord. The mass was removed via a hemilaminectomy in the cervical area using the ventral and dorsal approach, and a histological examination confirmed that it was adipose tissue. An infiltrative lipoma was diagnosed based on these findings. The dog has ambulated normally for 24 months since undergoing surgery.     

Diffuse bronchiolo-alveolar carcinoma in a dog

An eight-year-old female German wirehaired pointer was presented with signs of respiratory distress. Clinical examination, laboratory results, thoracic radiography and echocardiography indicated the presence of a diffuse interstitial lung disease with secondary appropriate erythrocytosis, pulmonary hypertension and cor pulmonale. Transthoracic fine needle aspiration biopsy of the lung suggested malignant epithelial neoplasia. A primary lung cancer with an unusually diffuse distribution of miliary/micronodular lesions was found at postmortem examination. Histological diagnosis was bronchiolo-alveolar carcinoma. Bronchiolo-alveolar carcinoma can occasionally occur in a diffuse fashion involving most or all of the lung parenchyma. In man, diffuse bronchiolo-alveolar carcinoma is considered a great imitator of other, more common diffuse interstitial forms of lung disease. This case report indicates that it is also a differential diagnosis to consider in dogs.     

Hepatocellular carcinoma in a young dog

A 25-month-old Chihuahua dog with no clinical signs was evaluated for high serum liver enzymes. Ultrasonography and computed tomography revealed a mass in the left hepatic medial lobe. The histological diagnosis reached using resected tissues was hepatocellular carcinoma (HCC). To the authors’ knowledge, this is the youngest dog diagnosed with HCC.     

Diffuse bronchiolo-alveolar carcinoma in a dog

An eight-year-old female German wirehaired pointer was presented with signs of respiratory distress. Clinical examination, laboratory results, thoracic radiography and echocardiography indicated the presence of a diffuse interstitial lung disease with secondary appropriate erythrocytosis, pulmonary hypertension and cor pulmonale. Transthoracic fine needle aspiration biopsy of the lung suggested malignant epithelial neoplasia. A primary lung cancer with an unusually diffuse distribution of miliary/micronodular lesions was found at postmortem examination. Histological diagnosis was bronchiolo-alveolar carcinoma. Bronchiolo-alveolar carcinoma can occasionally occur in a diffuse fashion involving most or all of the lung parenchyma. In man, diffuse bronchiolo-alveolar carcinoma is considered a great imitator of other, more common diffuse interstitial forms of lung disease. This case report indicates that it is also a differential diagnosis to consider in dogs.