Hepatoma in Cats (Felis) | Vetlexicon
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Hepatoma

ISSN 2398-2950

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Introduction

  • Primary hepatic tumors are rare in cats, accounting for approximately 1% of feline tumors.
  • Signs: large cranial abdominal mass, may be associated with gradual weight loss due to inappetence, +/- vomiting Vomiting.
  • Paraneoplastic hypoglycemia has been documented.
  • Diagnosis: diagnostic imaging, exploratory laparotomy Laparotomy: midline, biopsy and histopathology.
  • Treatment: liver lobectomy Lobectomy: liver.
  • Prognosis: good.

Presenting signs

  • Client may notice abdominal mass due to extension of abdomen.
    Abdominal distention more commonly noticed in cats due to their smaller size.
  • Weight loss.

Age predisposition

  • Older cats - average age for all hepatocellular tumors is >10 years.

Cost considerations

  • Requires surgical intervention.

Pathogenesis

Etiology

  • Unknown.
  • Benign tumor of hepatocytes.

Pathophysiology

  • Affects one liver lobe.
  • Degree and significance of clinical signs depends on lobe affected and size of tumor causing compression as a space occupying lesion.
  • Secondary effects may be seen due to presence of a large space-occupying mass within one liver lobe, eg compression of bile duct/gall bladder, compression on stomach.

Timecourse

  • Recognized late.
  • Often these tumors are large before signs seen, therefore may have been slow growing for many months.

Diagnosis

Presenting problems

  • Weight loss.
  • Vomiting.
  • Inappetence.
  • Often obvious abdominal mass.
  • Possible collapse/seizure from hypoglycemia.

Client history

  • Vague signs:
    • Inappetence.
    • Weight loss.
    • Lethargy +/- intermittent vomiting.
  • Client may see mass or complain of distended abdomen.
  • Collapse or seizure (hypoglycemia).

Clinical signs

  • Palpable abdominal mass in cranial abdomen.
  • Clinical icterus (uncommon).

Diagnostic investigation

Radiography

2D Ultrasonography

  • Valuable in localization, although with large tumors can be difficult to determine if mass is splenic or left liver lobe, but will permit better evaluation of other lobes (to rule out other metastases/metastases) and evaluate gall bladder.
  • Identify site for percutaneous ultrasound guided liver biopsy.
  • Define cystic structures.

Hematology

  • May be normal, or mild anemia (chronic disease).

Biochemistry

Cytology

  • Fine needle aspirate Fine-needle aspirate may help in differentiation of benign from malignant.
    Can be misleading, should always be submitted for a clinical pathologist to evaluate.

Histopathology

  • Definitive diagnosis necessary to differentiate benign from malignant hepatic tumors.
  • Samples may be collected by laparotomy biopsy or through percutaneous trucut biopsy - preferably with ultrasound guidance.

Confirmation of diagnosis

Discriminatory diagnostic features

  • History.
  • Clinical signs.
  • Imaging.

Definitive diagnostic features

  • Histopathology.

Gross autopsy findings

  • Discrete mass associated with one liver lobe.
  • May see compression of bile duct and distension of gall bladder, depends on size and location of tumor.
  • Hepatic congestion +/- icterus.

Histopathology findings

  • Tumor of hepatocytes lacking malignant characteristics.

Differential diagnosis

  • Other hepatic neoplasms:
    • Hepatocellular carcinoma.
    • Cystadenomas.
    • Plasmacytomas Plasmacytoma.
    • Myelolipomas.
    • Metastatic neoplasia.
  • Other causes of hepatomegaly :
    • Hematoma.
    • Acute hepatitis.
    • Congestion.
    • Fatty infiltration.

Treatment

Standard treatment

 

Prevention

Outcomes

Prognosis

  • Good with lobectomy Lobectomy: liver, survival times in excess of 2 years.
  • Guarded without lobectomy.
  • Main prognostic indicator is resectability, therefore early diagnosis is encouraged.

Expected response to treatment

  • Cessation of clinical signs.
  • Liver enzymes return to normal.

Reasons for treatment failure

  • Inability to resect tumor; regrowth if incompletely resected.
  • Peri-operative death due to complications of surgery, especially with relation to gall bladder.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Lawrence H J, Erb H N, Harvey H J et al (1994) Non-lymphomatous hepatobiliary masses in cats - 41 cases (1972-1991). Vet Surg 23 (5), 365-368 PubMed.
  • Post G & Patnaik A K (1992) Non-hematopoietic hepatic neoplasms in cats - 21 cases (1983-1988). JAVMA 201 (7), 1080-1082 PubMed.

Other sources of information

  • Liska W (?) Canine hepatomas and hepatocellular carcinomas. Semin An Med Center, New York.