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Background: Hepatic tumors of primary origin account for 0.6% to 2.9% of cases in canine species, less common than hepatic metastases. The hepatic tumors are divided into hepatocellular tumors, neuroendocrine tumors, bile duct tumors or cholangiocarcinomas, and mesenchymal tumors. Cholangiocarcinomas, are classified according to their origin, being intrahepatic, extrahepatic, or gallbladder type. Cholangiocarcinomas are considered rare in dogs and cats with a ratio of 29% to 71% compared to hepatocellular carcinomas, accounting for 9% of the hepatic tumors. The present study aims to describe a case of cholangiocarcinoma in a bitch, focusing on the diagnostic approach. Case: A 10-year-old castrated bitch Poodle was attended presenting hypoglycemia and seizure crisis. The patient had previous exams of hemogram and serum biochemical profile, showing a discrete increase of the hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST), besides hypoglycemia. Previous ultrasound exam revealed the presence of a hepatic mass located between the right and square lobes, immeasurable, and significant splenomegaly. Abdominal palpation revealed the presence of immeasurable abdominal formation of undetermined origin. Abdominal computerized tomography (CT), glycemic curve, and insulin dosage were requested. Tomography exam showed an increase in hepatic volume with the presence of a heterogeneous formation in the right lateral lobe topography; increase in spleen dimensions and the presence of multiple nodules; and the presence of a nodule in the right lung, at the caudal thoracic region. The glycemic curve showed acute variations, and insulin dosage was between normal values. The animal was referred for surgery, as in abdominocentesis, it was observed the presence of hemorrhagic fluid, confirming active bleeding by ultrasonography. The owners chose for euthanasia. In the post-mortem evaluation the main lesion was confirmed of hepatic origin, with a massive, irregular, cavitary presentation, involving multiple hepatic lobes, and a single nodule was observed in the right caudal lobe of the right lung. Histopathological evaluation was considered inconclusive. Immunohistochemistry was performed and the association of the immunohistochemical profile with the morphological characteristics indicated diagnosis of cholangiocarcinoma. Discussion: The related symptomatology, in hepatic neoplasms, is generally considered non-specific, with reports of lethargy, vomiting, dyspnea, anorexia and weight loss, however, the dog in this study presented a unique manifestation of hypoglycemia and one episode of convulsive crisis resulting from it. The clinical manifestation observed was extremely unspecific making initial diagnosis difficult. The ultrasonographic examination was effective in evidencing the abdominal mass. In addition, abdominal CT was also performed, which confirmed the hepatic origin, detailing the macroscopic aspect. Biochemical analyses of ALT and AST showed a discrete increase. Biochemical changes may occur in dogs with hepatic neoplasms, although they are not specific. Functional pancreatic beta-cell tumors producing insulin are the most common cause of paraneoplastic hypoglycemia, although in the case the insulin dosage was within normal limits. In cases of nonislet cell tumor the mechanism is frequently associated with the production of insulin-like growth factor (IGF). In most cases the definitive diagnosis of cholangiocarcinoma can be obtained by histopathological examination, although in the present report the result obtained was inconclusive, requiring an immunohistochemical examination. Due to the aggressive and metastatic character of this neoplastic type, early detection becomes extremely important in order to maximize therapeutic chances, however, diagnosis may be difficult.

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Background: The hepatocellular carcinoma (HCC) is a malignant neoplasm of hepatocytes of rare occurrence in farmanimals, with ruminants being the most affected species. This neoplasm is characterized by nonspecific symptoms and it isetiology in animals has not yet been fully elucidated, although aflatoxin has been shown to be a risk factor in the development this neoplasia. Since hepatic tumors in cattle are commonly incidental findings found in postmortem examination,the objective of this paper is to describe the clinical, laboratory and pathological findings in a cow with this neoplasm.Case: A 5-year-old, adult, Girolando cow weighing 350 kg was referred to the Veterinary Hospital of the Federal University of Recôncavo da Bahia, Brazil, with a history of decreased appetite and weakness for one month. The animal wasraised in a semi-intensive system, with a corn-based diet, and regular vaccination. Futhermore, was not treated at the farmof origin and three days before being admitted to the hospital, began to present edema of the dewlap. On examination atour center, the cow was in lean, active, with mucupurulent secretion in nostrils; ocular conjunctiva edema; and edema ofthe dewlap. The cow had neutrophilia, hypofibrinogemia, hypoproteinemia, and trombocytopenia. It also had tachycardia, tense abdomen, engorgement of the vessels of the face and jugular veins, stasis test and bilaterally positive jugularpulse. Although evidence of pain in reticulum was negative in the examination, the initial diagnostic suspicion establishedwas of traumatic reticular pericarditis. The therapeutic protocol instituted was daily monitoring, flunixin meglumine andflofernicol. The examination of rectal palpation revealed in the right flank an irregular-sized parenchymal structure withenlarged and palpacion in pain. Thus, by location and texture...(AU)

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Background: Cholangiocellular carcinoma is a malignant tumor that occurs mainly in elderly dogs and cats. Primaryhepatobiliary neoplasms are considered rare in felines, although cholangiocarcinoma is the most common tumor typeamong malignant liver tumors in the species. The objective of this work is to report two cases of cholangiocarcinoma inyoung domestic cats, with three years old, and to approach clinical and pathological aspects to promote awareness of thistype of injury in young animals, with a focus on prevention of predisposing factors.Cases: A 3-year-old male domestic cat (cat 1) had a history of progressive weight loss, persistent vomiting, diarrhea,and episodes of seizure. At the clinical examination was noted moderate degree of jaundice. In the biochemical exams itwas verified as alteration hypoproteinemia, increase of urea and hyponatremia. Abdominal ultrasonography revealed aformation in the left epigastric region measuring 8.0 x 5.0 cm, with a diffusely heterogeneous parenchyma, suggestive ofhepatic neoplasia, in addition to the presence of free abdominal fluid. Cavity fluid analysis was suggestive of carcinoma.A 3-year-old male domestic cat (cat 2), with history of hyporexia, emaciation and vomiting was taken to care. Physicalexamination showed moderate dehydration, hypocorous mucosa and presence of abdominal mass on palpation. The animals serum biochemical assessment were verified as changes, increasing AST. Ultrasonographic examination showedan abdominal mass, located caudally to the spleen, with irregular shape, measuring approximately 4.7 cm suggestive ofhepatic neoplasia, in addition to the presence of abdominal fluid. The hepatic cytology performed by fine needle aspiration was suggestive of carcinoma. After the clinical worsening of two cats and due unfavorable prognosis, euthanasia andnecropsy were performed. In the macroscopic...(AU)

Assuntos

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Background: Cholangiocellular carcinoma is a malignant tumor that occurs mainly in elderly dogs and cats. Primaryhepatobiliary neoplasms are considered rare in felines, although cholangiocarcinoma is the most common tumor typeamong malignant liver tumors in the species. The objective of this work is to report two cases of cholangiocarcinoma inyoung domestic cats, with three years old, and to approach clinical and pathological aspects to promote awareness of thistype of injury in young animals, with a focus on prevention of predisposing factors.Cases: A 3-year-old male domestic cat (cat 1) had a history of progressive weight loss, persistent vomiting, diarrhea,and episodes of seizure. At the clinical examination was noted moderate degree of jaundice. In the biochemical exams itwas verified as alteration hypoproteinemia, increase of urea and hyponatremia. Abdominal ultrasonography revealed aformation in the left epigastric region measuring 8.0 x 5.0 cm, with a diffusely heterogeneous parenchyma, suggestive ofhepatic neoplasia, in addition to the presence of free abdominal fluid. Cavity fluid analysis was suggestive of carcinoma.A 3-year-old male domestic cat (cat 2), with history of hyporexia, emaciation and vomiting was taken to care. Physicalexamination showed moderate dehydration, hypocorous mucosa and presence of abdominal mass on palpation. The animal’s serum biochemical assessment were verified as changes, increasing AST. Ultrasonographic examination showedan abdominal mass, located caudally to the spleen, with irregular shape, measuring approximately 4.7 cm suggestive ofhepatic neoplasia, in addition to the presence of abdominal fluid. The hepatic cytology performed by fine needle aspiration was suggestive of carcinoma. After the clinical worsening of two cats and due unfavorable prognosis, euthanasia andnecropsy were performed. In the macroscopic...

Assuntos

RESUMO

Background: The hepatocellular carcinoma (HCC) is a malignant neoplasm of hepatocytes of rare occurrence in farmanimals, with ruminants being the most affected species. This neoplasm is characterized by nonspecific symptoms and it isetiology in animals has not yet been fully elucidated, although aflatoxin has been shown to be a risk factor in the development this neoplasia. Since hepatic tumors in cattle are commonly incidental findings found in postmortem examination,the objective of this paper is to describe the clinical, laboratory and pathological findings in a cow with this neoplasm.Case: A 5-year-old, adult, Girolando cow weighing 350 kg was referred to the Veterinary Hospital of the Federal University of Recôncavo da Bahia, Brazil, with a history of decreased appetite and weakness for one month. The animal wasraised in a semi-intensive system, with a corn-based diet, and regular vaccination. Futhermore, was not treated at the farmof origin and three days before being admitted to the hospital, began to present edema of the dewlap. On examination atour center, the cow was in lean, active, with mucupurulent secretion in nostrils; ocular conjunctiva edema; and edema ofthe dewlap. The cow had neutrophilia, hypofibrinogemia, hypoproteinemia, and trombocytopenia. It also had tachycardia, tense abdomen, engorgement of the vessels of the face and jugular veins, stasis test and bilaterally positive jugularpulse. Although evidence of pain in reticulum was negative in the examination, the initial diagnostic suspicion establishedwas of traumatic reticular pericarditis. The therapeutic protocol instituted was daily monitoring, flunixin meglumine andflofernicol. The examination of rectal palpation revealed in the right flank an irregular-sized parenchymal structure withenlarged and palpacion in pain. Thus, by location and texture...

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O cistoadenoma biliar intra-hepático é neoplasia benigna rara, que se apresenta como lesão cística multisseptada. Essa afecção é considerada lesão pré-maligna. O tratamento tem sido ressecção completa. Atualmente, a hepatectomia maior laparoscópica é aceita como preferencial em afecções hepáticas benignas devido à baixa morbidade e ao melhor resultado estético. Relata-se o caso de um doente com cistoadenoma biliar intra-hepático, tratado com hemi-hepatectomia direita laparoscópica. Houve bom curso pós-operatório sem recidiva do tumor nos doze mesesde seguimento. O tratamento do cistoadenoma biliar intra-hepático por hemi-hepatectomia direita laparoscópica apresenta baixa morbidade e bom resultado estético.

Intra-hepatic biliary cystadenoma is a rare benign neoplasm presented as multisepted cystic lesion. This affection has been considered a premalignant lesion. Treatment has been complete resection. Nowadays, laparoscopic major hepatectomy has been accepted as preferential treatment for benign hepatic diseases due to both low morbidity andbest aesthetic result. The authors present a case of intra-hepatic biliary cystadenoma treated with laparoscopic right hemi-hepatectomy. The patient presented good postoperative course without tumor recurrence after a twelve month follow-up period. Intra-hepatic biliary cystadenoma treatment with laparoscopic right hemi-hepatectomy presentsboth low morbidity and good aesthetic result

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O tratamento das doenças hepatobiliares através de hepatectomias centrais tem sido um dos desafios técnicos mais importantes para a cirurgia neste final de século. Embora diversas técnicas tenham sido utilizadas nas últimas décadas, só recentemente estas têm sido executadas com segurança, diminuindo drasticamente as taxas de morbi-mortalidade, e com isso propiciando resultados favoráveis no tratamento das diferentes afecções hepáticas. Quer o figado apresente-se ou não com hepatopatia crônica, a integração de equipes multidisciplinares afeitas a este tipo de cirurgia e de patologia, permitiu que ressecções complexas fossem realizadas. Com o princípio de manter massa e função hepatocitária remanescente viáveis, o estudo morfológico e funcional do fígado no pré-operatório impõe que técnicas de transplante de segmentos hepáticos sejam freqüentemente utilizadas, seja na reconstrução vascular, seja na redução e conservação de massa hepática. Desta maneira, a ressecção de qualquer parte do fígado com o mínimo de utilização de derivados sangüíneos tem se mostrado factível através do conhecimento apurado da anatomia hepática e da utilização de ecografia transoperatória. Deste trabalho de revisão de diferentes técnicas de hepatectomias centrais são apresentadas, discutidas as indicações e detalhes cirúrgicos de cada uma delas.

The treatment of hepatobiliary diseases by central hepatectomies has been one of the most important challenges in surgical technique at the end of this century. Although different techniques were used in the last decades, only recently they have been carried out safely, drastically reducing the morbidity and mortality rates, and thus providing favorable results in treating different hepatic diseases. Whether the liver does or not present chronic liver disease, the integration of related multiple-disciplinary teams in this type of surgery and disease has allowed complex ablations, sometimes bordering on the limit of the possibility of life. Based on the principle of maintaining a viable remaining hepatocyte mass and function, the morphological and functional study of the liver during the preoperative period requires the frequent use of techniques to transplant liver segments, both for vascular reconstruction and for the reduction and conservation of the liver mass. Thus, the resection of any part of the liver with a minimum use of blood products has proved feasible with thorough knowledge of the anatomy of the liver, and the use of echography during surgery. Different central hepatectomy techniques are, thus, presented, discussing indications and surgical details of each of them.