Cystadenoma in Geriatric Feline

Patient Information:

Age: 14 years
Gender: Spayed Female
Breed: DSH
Species: Feline

History:

Patient presented with a history of hyporexia. Liver values were elevated on blood work and large mass associated with the liver was visualized on radiographs.

Ultrasonographic Findings:

There is a severely capsule deforming pedunculated hyperechoic loculated mass containing a single large anechoic cyst present in the distal right medial liver measuring 4.4x5.1cm. The rest of the liver is normal size, shape and echogenicity. The gallbladder is of normal size and shape and is clean. The common bile duct (1.5mm) and duodenal papilla (3.4mm) are WNL.

Abdominal Ultrasound Interpretation:

Right Liver Mass - the finding is severe - DDX: cystadenoma, well-differentiated cystadenocarcinoma or biliary adenocarcinoma. Hepatocellular carcinoma or hepatoma cannot be ruled-out without biopsy.

Large cyst associated with loculated hyperechoic right liver mass.

Treatment:

The rdvm performed a complete excisional biopsy of the liver mass.

Histopathology Results:

Biliary Cystadenoma with clean margins

Outcome:

The patient made a full recovery with normalization of liver values at the 1 month recheck and complete resolution of clinical signs.

Discussion

These masses are generally non-malignant/benign but can create clinical signs based on their shear size and space-occupying nature. Where possible, surgical resection is the best therapy for these lesions. Sometimes, these masses are close to the hepatic vasculature and/or biliary system which can make surgical resection difficult. Fortunately, in this case, the mass was present on the distal right liver so it was amenable to surgical resection.

Thank you to Hope Animal Hospital and Dr. Faiz Ahmad for providing surgical pictures and collaborating with us on this interesting case!