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      Severe pericardial effusion in a cat with peritoneopericardial diaphragmatic hernia and incarcerated hepatic sarcoma


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          Case summary

          A 4-year-old female neutered domestic longhair cat was presented at a referral hospital for dyspnoea with a history of suspected pleural effusion. Thoracic ultrasonography demonstrated a large-volume pericardial effusion causing cardiac tamponade and a cystic mass within the pericardium. CT revealed a peritoneopericardial diaphragmatic hernia (PPDH) caused by a defect of the ventral diaphragm. Herniated contents consisted of the right lateral and caudate liver lobes, and an associated cystic hepatic mass. Ventral midline coeliotomy was performed for herniorrhaphy and partial pericardiectomy, together with lobectomy of the incarcerated liver mass. Histopathology and immunohistochemistry diagnosed a poorly differentiated hepatic sarcoma with inflammation and remodelling in the adjacent incarcerated liver parenchyma. The patient developed metastatic sarcoma 2 months after surgery and was euthanased as a result.

          Relevance and novel information

          Pericardial effusion causing cardiac tamponade is a previously unreported sequelae to PPDH in cats. Reports on the presence of malignancy in incarcerated liver are scarce and the location is not typical for a sarcoma in this species.

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          Most cited references22

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          Feline injection-site sarcoma: ABCD guidelines on prevention and management.

          In cats, the most serious of adverse effects following vaccination is the occurrence of invasive sarcomas (mostly fibrosarcomas): so-called 'feline injection-site sarcomas' (FISSs). These develop at sites of previous vaccination or injection. They have characteristics that are distinct from those of fibrosarcomas in other areas and behave more aggressively. The rate of metastasis ranges from 10-28%.
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            A review of the pathophysiology, classification, and analysis of canine and feline cavitary effusions

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              A morphologic and immunocytochemical study of hepatic neoplasms in cats.

              A Patnaik (1992)
              A retrospective study was done of 47 neoplasms of the hepatic and biliary systems from 47 cats brought to The Animal Medical Center over a period of 10 years (1980 to 1989). Histologic examination of specimens taken at necropsy revealed that 87% (41/47) of the hepatic neoplasms were epithelial and 13% (6/47) were nonepithelial. Of the epithelial tumors, 25/47 (53%) were of intrahepatic bile duct origin, 9/47 (19%) were of hepatocellular origin, 5/47 (11%) involved the extrahepatic bile ducts, and 2/47 (4%) were adenocarcinomas of the gall bladder. Of the nonepithelial neoplasms, hemangiosarcomas were more common, 5/47 (11%), than leiomyosarcomas, 1/47 (2%). Multiple liver lobes were involved in 21/34 (62%) of the epithelial and all six of the nonepithelial intrahepatic neoplasms. Most of the bile duct adenocarcinomas (6/9) were predominantly characterized by acinar structures with mucin production, diffuse necrosis, and little desmoplasia. The hepatocellular carcinomas were characterized by three patterns-trabecular (five tumors), pseudoglandular pattern (two tumors), and anaplastic (one tumor). The hepatic carcinoid was characterized by various-sized groups of acinar and rosettelike structures, some with lumens, separated by thin fibrovascular stroma. The extrahepatic bile duct adenocarcinomas (4/4) were acinopapillary with moderate desmosplasia, whereas the adenocarcinomas of the gall bladder had elongated tubular structures lined by anaplastic cells and a severe desmoplastic reaction. The neuroendocrine carcinoma of the extrahepatic bile duct, the hemangiosarcomas, and the leiomyosarcoma had morphologic features characteristic of these neoplasms. Two of the 16 (13%) bile duct adenomas had anaplastic and precancerous changes. Residual benign components were seen in 10/15 (67%) of the biliary adenocarcinomas, 4/9 (44%) of the intrahepatic bile duct adenocarcinomas, and all of the extrahepatic bile duct adenocarcinomas and gall bladder adenocarcinomas. Results of immunohistochemical studies of the biliary neoplasms were similar to those described in studies of biliary neoplasms in human beings. Results of this study revealed that the frequency of different types of hepatic neoplasms in cats varied from that seen in dogs and human beings, but the morphologic features were comparable.

                Author and article information

                JFMS Open Rep
                JFMS Open Rep
                JFMS Open Reports
                SAGE Publications (Sage UK: London, England )
                17 September 2022
                Jul-Dec 2022
                : 8
                : 2
                : 20551169221121926
                [1 ]Peninsula Vet Emergency and Referral Hospital, Melbourne, Victoria, Australia
                [2 ]ASAP Laboratory, Melbourne, Victoria, Australia
                Author notes
                [*]Susan V Ciaravolo BSc, DVM, MANZCVS (Medicine), Peninsula Vet Emergency and Referral Hospital, 2/161 Mornington-Tyabb Road, Mornington, VIC 3931, Australia Email: susan@ 123456penvetreferral.com.au
                © The Author(s) 2022

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                Case Report
                Custom metadata
                July-December 2022

                peritoneopericardial diaphragmatic hernia,sarcoma,pericardial effusion,cardiac tamponade


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