Case summary
A 14-year-old female neutered Persian-cross cat was presented with a 1 week history of anorexia and lethargy. On physical examination, marked tachypnoea and dyspnoea were evident. Radiographs of the thorax revealed a globoid-shaped cardiac silhouette with heterogeneous opacity consistent with a peritoneopericardial diaphragmatic hernia (PPDH), pulmonary nodules compatible with metastasis, seven sternal segments and a small liver in the cranial abdomen with loss of serosal detail. On echocardiography, there was no evidence of cardiac tamponade. Triple-phase CT angiography demonstrated a mixed soft tissue-, mineral- and fat-attenuated liver mass arising from the left hepatic lobes that showed a pronounced heterogeneous contrast-enhancement pattern within the pericardial sac, which was producing a marked mass effect on the adjacent structures. Additionally, there was an increase in attenuation of the mesenteric fat and peritoneal effusion. The pulmonary nodules were confirmed. Imaging findings were compatible with a malignant hepatic neoplasia incarcerated in a PPDH, lung metastasis and carcinomatosis. Owing to the poor prognosis, the cat was humanely euthanased. Histopathological diagnosis was cholangiocellular carcinoma and hepatic myelolipoma, pulmonary metastasis and carcinomatosis.
Relevance and novel information
Hepatic cholangiocarcinoma incarcerated in a PPDH with pulmonary metastasis and carcinomatosis has not been previously described. Suspicion of a hepatic neoplasia should be raised in cases of PPDH and pulmonary nodules.
Hypertrophic cardiomyopathy (HCM) is characterized by an abnormal increase in myocardial mass that affects cardiac structure and function. HCM is the most common inherited cardiovascular disease in humans (0.2%) and the most common cardiovascular disease in cats (14.7%). Feline HCM phenotype is very similar to the phenotype found in humans, but the time frame for the development of the disease is significantly shorter. Similar therapeutic agents are used in its treatment and it has the same complications, such as heart failure, thromboembolism and sudden cardiac death. In contrast to humans, in whom thousands of genetic variants have been identified, genetic studies in cats have been limited to fragment analysis of two sarcomeric genes identifying two variants in MYBPC3 and one in MYH7. Two of these variants have also been associated with human disease. The high prevalence of the reported variants in non‐affected cats hinders the assumption of their pathogenicity in heterozygotes. An in‐depth review of the literature about genetic studies on feline HCM in comparison with the same disease in humans is presented here. The close similarity in the phenotype and genotype between cats and humans makes the cat an excellent model for the pathophysiological study of the disease and future therapeutic agents.
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