Search

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., (Copyright © 2020 Ko, Hwang, Yoon, Eom and Kim.)

Giant pedunculated hepatocellular adenomas are extremely rare tumors and often detected incidentally on cross-sectional imaging studies. We report the case of a 34-year-old woman who underwent cross-sectional imaging for staging evaluation of a uterine tumor. A large left subdiaphragmatic mass, without clear connection to the liver, was seen prompting diagnostic laparoscopy; during which a large pedunculated mass attached to the left lobe of the liver was found and resected. This case report highlights the challenges and pitfalls in the imaging diagnosis of pedunculated hepatocellular adenomas, such as difficulty in characterizing the mass or inability to identify the vascular attachment to the liver. Image-guided biopsy and diagnostic laparoscopy are valuable tools to establish diagnosis; most of these lesions are amenable to laparoscopic resection., (© 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)