ISSN 2398-2969      

Liver: neoplasia

icanis

Introduction

Age predisposition

  • Metastatic or systemic neoplasia: any age.
  • Primary hepatobiliary neoplasia: older dogs >10 years:
    • Median age of dogs with benign disease is greater than those with malignant tumors.

Sex predisposition

  • Males for hepatocellular carcinoma.

Special risks

  • May have coagulopathy due to liver dysfunction.

Pathogenesis

Etiology

  • None determined for dogs; hepatitis B or C viral infection and cirrhosis are factors in people.

Predisposing factors

General
  • Intrahepatic bile duct carcinomas have been associated with liver fluke infestation.

Pathophysiology

  • Normal hepatic architecture disrupted by neoplastic cells.
  • If large areas of liver involved → hepatic dysfunction/failure.
  • Neoplasm may obstruct biliary tree → jaundice.
  • Neoplasm may cause portal hypertension → ascites.
  • Primary hepatic tumors may be solitary lobar masses or multiple discrete nodules in more than one lobe.
  • Metastatic neoplasms may be diffuse infiltrates or multifocal nodules.

Primary hepatobiliary tumors

  • Hepatocellular carcinomamost common, less likely to metastasize.
  • Bile duct adenocarcinoma(biliary cystadenoma or hepatobiliary cystoadenoma) is benign and the most common liver tumor. These are multicystic or spongiform structures containing clear or blood-tinged fluid.
  • Bile duct carcinoma (cholangiocarcinoma) is the second most common primary malignant liver tumor. Approximately 60% have metastasized to lungs, lymph nodes and most commonly intestinal serosa (carcinomatosis) by the time of diagnosis.
  • Other uncommon liver tumors are gall bladder adenocarcinoma, biliary carcinoid, hemangiosarcoma and leiomyosarcoma.
  • Neoplasms of biliary tract origin are more common than those of hepatic cell origin.
  • Tumors may be a single lobar mass or multiple discrete nodules involving one or more lobes.
  • Vomiting may result from pressure on stomach or from hepatic dysfunction.
  • Jaundice may result from hepatic dysfunction or obstruction of the biliary tree.
  • Signs of liver failure are seen when the liver is extensively infiltrated, but not when the disease is confined to one lobe/area.

Metastatic neoplasia

Myelipomas

  • Tumor-like nodules composed of mature adipose tissue and bone marrow elements, may rarely occur in the liver.

Timecourse

  • Often insidious onset.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Patnaik A K, Newman J et al (2005) Canine hepatic neuroendocrine carcinoma: an immunohistochemical and electron microscopic study. Vet Pathol 42 (2), 140-146 PubMed.
  • Liptak J M, Dernell W S et al (2004) Massive hepatocellular carcinoma in dogs: 48 cases (1992-2002). JAVMA 225 (8), 1225-1230 PubMed.
  • O'Brien R T, Iani M et al (2004) Contrast harmonic ultrasound of spontaneous liver nodules in 32 dogs. Vet Radiol Ultrasound 45 (6), 547-553 PubMed.
  • Wang K Y, Panciera D L et al (2004) Accuracy of ultrasound-guided fine-needle aspiration of the liver and cytologic findings in dogs and cats: 97 cases (1990-2000). JAVMA 224 (1), 75-78 PubMed.
  • Cohen M, Bohling M W et al (2003) Evaluation of sensitivity and specificity of cytologic examination: 269 cases (1999-2000). JAVMA 222 (7), 964-967 PubMed.
  • Cuccovillo, A, Lamb C R (2002) Cellular features of sonographic target lesions of the liver and spleen in 21 dogs and a cat. Vet Radiol Ultrasound 43 (3), 275-278 PubMed.
  • Vörös K, Vrabély T, Papp L et al (1991) Correlation of ultrasonographic and pathomorphological findings in canine hepatic diseases. J Small Anim Pract 32 (12), 627-634 VetMedResource.

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