Liver: primary hepatic neoplasia

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Sections available in full article Introduction, Age predisposition, Sex predisposition, Pathogenesis, Etiology, Diagnosis, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Subsequent management, Sequelae, Prognosis, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Irene Rochlitz BVSc MSc PhD
Dr William Brewer Jr DVM DiplACVIM Oncology and Internal Medicine
Dr Laura Garrett DVM DACVIM (Oncology)
Mr Gerry A Polton MA VetMB MSc(Clin Onc) DipECVIM-CA(Onc) MRCVS European Veterinary Specialist in Oncology

Introduction

  • Primary hepatic neoplasia is rare (approximately 2% of all tumors).
  • Most common neoplasia of liver in cats is lymphoma  Lymphoma  .
  • Broadly speaking, there are four different morphologic types of primary liver cancer in cats:
    • Biliary adenoma/carcinoma (64%).
    • Hepatocellular adenoma/carcinoma (19%).
    • Mesenchymal (sarcoma) (13%), most frequently hemangiosarcoma (11%)  Hemangiosarcoma  .
    • Carcinoid (4%).
  • Signs : usually non-specific such as weight loss, anorexia and vomiting; rarely clinical signs of hepatic dysfunction including icterus; many cases are asymptomatic.
  • Diagnosis : radiography, ultrasonography, laboratory tests, cytopathology or histopathology. Clinical stage: CT/MRI, ultrasound, radiography.
  • Treatment : surgical resection for solitary masses. Multifocal masses are best managed by palliative care.
  • Prognosis : guarded unless tumor solitary and surgical resection possible.

Diagnosis

Clinical signs

  • Physical examination may be normal.
  • Hepatomegaly  Hepatomegaly   or large cranial abdominal mass on palpation (50% cases).
  • Jaundice  Jaundice  .
  • Ecchymotic hemorrhage, abnormal hemostasis.
  • Ascites  Ascites 01: whole cat     Ascites 02: whole cat   Ascites 03: whole cat  .
  • Cranial abdominal pain.

Diagnosis

Differential diagnosis

  • Nodular hyperplasia.
  • Cirrhosis   Liver: cirrhosis   with regenerative nodules.
  • Secondary liver neoplasia including lymphoma.
  • Other abdominal masses.
  • Hepatic amyloidosis  Amyloidosis  .
  • Other chronic liver diseases  Liver: chronic disease  .
  • Other causes of hepatomegaly  Hepatomegaly  , eg right-sided heart failure.

Sequelae

Prognosis

  • Excellent following complete resection of solitary benign tumor.
  • Most cases with malignant tumors die shortly after diagnosis.

Reasons for treatment failure

  • Inaccurate pre-surgical clinical stage determination.
  • Proximity of tumor to great vessels.
  • Systemic complications of hepatic dysfunction.
  • Lack of inherent responsiveness to chemotherapy.

Sources

Publications

Refereed papers

  • Recent references fromPubMed.
  • Wang K Y, Panciera D Let al(2004)Accuracy of ultrasound-guided fine-needle aspiration of the liver and cytologic findings in dogs and cats: 97 cases (1990-2000).JAVMA224(1), 75-78PubMed.
  • Cohen M, Bohling M Wet al(2003)Evaluation of sensitivity and specificity of cytologic examination: 269 cases (1999-2000).JAVMA222(7), 964-967PubMed.
  • Lawrence H J, Erb H N & Harvey H J (1994)Nonlymphomatous hepatobiliary masses in cats - 41 cases (1972 to 1991).Vet Surg23(5), 365-368PubMed.
  • Post G & Patnaik A K (1992)Nonhematopoietic hepatic neoplasms in cats: 21 cases (1983-1988).JAVMA201, 1080-1082.
  • Patnaik A K (1992)A morphologic and immunocytochemical study of hepatic neoplasms in cats.Vet Pathol29, 40-415.

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