These arrows point to the mass deriving from the caudate bridge.
This image shows where the caudal mass escapes into the omentum.
History
Corgi/Pomeranian Mix, FS, 11 years. Elevated hepatic enzymes, decreased detail in cranial abdomen on radiographs. History of chronic bronchitis- stable on prednisone 5mg EOD. Suspect acute CCL injury 3 days ago- started on tramadol. Medications: Prednisone 5mg SID-EOD, tramadol 50mg 1 PO TID PRN.
Image Interpretation
The liver presented moderately complex parenchymal mass that measured 11.2 cm with cavitation. The liver mass derived from the caudate process. The cranial liver appeared unremarkable. The liver mass appears resectable. A bridge of the caudate process to the mass measured approximately 2.5 cm or 1 inch. Regional inflammation was noted around the mass with variable areas of cavitation. This is suggestive for necrosis. Minor, micronodular changes were noted in the left cranial liver as well as right cranial liver. However, no significant disruption of architecture was noted.
Sonographic Differential Diagnosis
Large, microcavitated hepatic mass that was deriving from the caudate process. This appears resectable. Suspect hepatocellular carcinoma.
Minor age related bladder and renal changes.
DX
Suspected hepatocellular carcinoma
Outcome
Surgical intervention is recommended. Urinary work-up is warranted if not already performed. The inflammation is associated with the mass. The mass is at risk for torsion. Some capsular escape deriving from the caudal aspect of the mass surrounded by regional omental, inflammatory pattern.
Videos
The liver mass can be seen in this clip.
The liver mass can be seen on the right side of the screen in this clip
