hepatobiliary tumors.
Abdominal
ultrasound is the preferred method
for identifying and characterizing
hepatobiliary tumors in dogs and
cats. 2 However, the ability to
differentiate
ultrasonagraphically
benign from malignant hepatobiliary
disease process is lacking. In human
medicine, MRI and CT have largely
surpassed the diagnostic capability of
ultrasound for the characterization of
focal hepatic and splenic lesions. A
study has showed that MRI allows for
better differentiation of benign from
malignant hepatic lesions in veterinary
patients. 5 Cost and anesthesia remain
the two largest barriers for hepatic MRI
in veterinary patients. 6 One study has
showed low sensitivity of a fine needle
aspirate with complete agreement in
37% of the cases. 7 Ultimately,
histopathology
is
necessary
to
establish a diagnosis.
Liver lobectomy is the preferred
treatment for massive or solitary
hepatic nodules. However, the
prognosis is often poor for hepatic
sarcomas due to presence of
metastatic disease at the time of
surgery. 4 Chemotherapy has not
been investigated in the treatment
of primary hepatic sarcomas but like
most solid sarcomas, response is
often poor. 2 The type of liver
lobectomy performed (stapling, suture
mass ligation, finger fracture or
mattress suture techniques) has no
association with survival. The most
common complication associated with
this type of procedure is hemorrhage
(5%-13%). Death during the surgical
procedure is highly unlikely and
surgical
complications
have
no
Figure 5: Note large liver mass (arrow)
pushing the gallbladder (x) to the left side
of the abdominal wall.
significant association with survival.
However, in one retrospective study, 4/7
dogs that had a difficult anesthetic
recovery
(depressed/hypotensive)
ultimately arrested. 4
Outcome:
Gizmo has returned several times for
follow up re-evaluations.
Nine
months post operatively, his liver
enzymes have decreased significantly.