Hepatocellular carcinoma in a green iguana – a case study

Zdeněk Knotek,Pavel Proks,Anna Hrdá,Vladimír Jekl,William Lewis,Aleš Tomek,Gerry M Dorrestein,Zora Knotková

doi:10.2754/avb201180030243

Abstract

A 3.10 kg, six-year old male green iguana (Iguana iguana) suffered several weeks of decreased activity, loss of body weight, anorexia and change of skin colour. Physical examination revealed a cachectic depressed lizard, with marked pale mucous membranes. The complete blood count revealed a leukocytosis (46.5 × 109/l), elevated heterophils (23.25 × 109/l) and azurophils (23.25 × 109/l), decreased haemoglobin concentration (29.00 g/l), low haematocrit (0.16 l/l) and erythropenia (0.35 × 1012/l). Abnormalities of the plasma chemistry panel included increased activity of aspartate aminotransferase (6.05 μkat/l) and creatinephosphokinase (217.91 μkat/l), increased concentrations of uric acid (321.58 μmol/l), phosphorus (4.04 mmol/l) and bile acids (120.21 μmol/l), as well as a decreased concentration of glucose (3.72 mmol/l), cholesterol (0.637 mmol/l) and triglycerides (0.09 mmol/l). A lateral radiograph revealed soft-tissue opacity present in the region of the liver. Magnetic resonance imaging showed a markedly enlarged left liver lobe distended caudally and displacing the other abdominal organs. The signal intensity of the liver parenchyma was slightly hyperintense, the ventro-medial part of the left lobe showed a hypointense signal. Endoscopic examination of the coelomic cavity revealed a greatly enlarged pale liver and the presence of a straw-coloured modified transudate. Based on histopathological examination of the liver hepatocellular carcinoma was diagnosed. Despite supportive treatment the patient died on the sixth day of hospitalisation.

Highlights

The activity of alkaline phosphatase (ALP), ALT, AST and creatinephosphokinase (CPK), as well as concentration of total protein, glucose, uric acid, cholesterol, triglycerides (TAG) and phosphorus was determined with a CobasMira analyzer (Roche, Switzerland); plasma concentrations of calcium were determined using a AA Series Spectrometer (Thermo Electron Corporation, UK)
Hepatocellular carcinomas have been previously reported in a five-lined skink (Eumeces fasciatus) and an inland bearded dragon (Pogona vitticeps) (Griswold 2001)
In the present case of hepatocellular carcinoma in a green iguana, heterophilia was associated with low numbers of erythrocytes, low haematocrit and a low concentration of haemoglobin

Summary

Introduction

Abnormalities of the plasma chemistry panel included increased activity of aspartate aminotransferase (6.05 μkat/l) and creatinephosphokinase (217.91 μkat/l), increased concentrations of uric acid (321.58 μmol/l), phosphorus (4.04 mmol/l) and bile acids (120.21 μmol/l), as well as a decreased concentration of glucose (3.72 mmol/l), cholesterol (0.637 mmol/l) and triglycerides (0.09 mmol/l). A lateral radiograph revealed soft-tissue opacity present in the region of the liver. Magnetic resonance imaging showed a markedly enlarged left liver lobe distended caudally and displacing the other abdominal organs.

Results

Conclusion