Abstract
This study describes the multimodal imaging characteristics of pedunculated liver masses in seven dogs [Cocker Spaniel (n = 2), Maltese (n = 1), Shih-Tzu (n = 2), and Schnauzer (n = 2)]. These masses are anatomic variants of hepatic masses in which the center of the mass lies outside the liver contour. Prior to referral, only one dog had been diagnosed with a hepatic mass, four had been diagnosed with mid-abdominal masses of unknown origin, and two had been misdiagnosed with splenic head and pancreatic masses. Using radiographs, the mass locations were classified as cranioventral (n = 3), mid-abdominal (n = 2), or craniodorsal (n = 2). The gastric axis was deviated in various directions in four cases. Based on computed tomography (CT) findings, the masses were noted to originate from every liver lobe (two from the left lateral lobe) and to possess parenchymal (n = 6) or vascular (n = 1) pedicles. The histopathological results showed that three masses were benign [hepatic adenoma (n = 1) and nodular hyperplasia (n = 2)] and four were malignant [hepatocellular carcinoma (n = 3) and cholangiocarcinoma (n = 1)]. For three dogs, triple-phase CT maximum intensity projection images in the arterial phase clearly showed that the masses were connected to the hepatic artery. We propose that a pedunculated liver mass should be considered as a differential diagnosis when a mass is located in the mid-abdomen, even if it is separated from the liver and with the gastric axis deviated in various directions. We consider CT imaging to be a useful tool for diagnosis, evaluation, and surgical planning in dogs with a pedunculated liver mass.
Highlights
A pedunculated or exophytic liver mass is defined as a protruding mass that is connected to the liver by a pedicle and has a center that lies beyond the contour of the liver [1, 2]
One out of the seven dogs had been correctly diagnosed with a hepatic mass prior to referral
The pedicle connecting the mass and the liver was overlooked on the initial ultrasonographic examination by an experienced practitioner in one case; it was identified on follow-up US after computed tomography (CT) had identified the connection, indicating that identifying the pedicle can be challenging on ultrasonographic examination
Summary
A pedunculated or exophytic liver mass is defined as a protruding mass that is connected to the liver by a pedicle and has a center that lies beyond the contour of the liver [1, 2]. The differential diagnoses for this type of mass are the same as those for other benign (e.g., hepatic cyst, focal nodular hyperplasia, hepatocellular adenoma, etc.) or malignant (e.g., hepatocellular adenocarcinoma, cholangiocarcinoma, etc.) hepatic masses. This type of mass is rare in animals as well as in humans [3]; a careful evaluation of masses that initially appear to arise in the mid-abdomen is important since a pedunculated hepatic mass may be mistaken for one originating from a different organ, such as the stomach, small intestine, pancreas, and mesenteric lymph node, while those arising more dorsally may be mistaken for the adrenal gland [4,5,6]. The aim of this study was to describe the radiographic, ultrasonographic, and CT features of pedunculated liver masses in dogs
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