Feline gastrointestinal eosinophilic sclerosing fibroplasia presenting as a rectal mass

Abstract

Case summary A 9-year-old neutered male cat was referred owing to dyschezia and weight loss. Abdominal CT revealed a heterogeneous mass in the rectum and thickening of one caudal mesenteric lymph node. The mass induced a focal rectal obstruction. Cytological evaluation of fine-needle aspirates showed signs of mixed inflammation for the rectal mass and a reactive lymph node. Because a definite diagnosis was not achieved, complete resection of the mass via a dorsal approach to the rectum was attempted. Histopathology confirmed complete removal and diagnosed feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). The cat was treated with psyllium husks and lactulose after surgery. In the postoperative year, the owner reported normal behaviour, food intake and defecation of the patient. Dyschezia reoccurred 14 months after surgery. Imaging revealed recurrence of a rectal mass. Owing to clinical deterioration, the owner elected for euthanasia. Relevance and novel information This is the first report of rectal FGESF with dyschezia and weight loss as the main clinical signs. The case demonstrates an acceptable outcome for more than 1 year without additional immunosuppressive therapy, and emphasises that FGESF must be considered as a differential diagnosis for rectal masses in cats.

Feline gastrointestinal eosinophilic sclerosing fibroplasia in two cats: Serial ultrasonographic and computed tomography findings

“…Similarly, research on CT studies of FGESF remains limited, with only two reported cases of FGESF located in the extramural retroperitoneal area and rectum (Lawrance et al 2001;Thieme et al 2019). In these two cases, FGESF showed heterogeneous contrast enhancement on CT, in contrast with our case, which illustrated mild homogeneous contrast enhancement (Thieme et al 2019;Goffart et al 2022). Considering the absence of necrotic lesions on the histological examination in case 1, the contrast enhancement pattern difference is likely attributable to the presence or absence of necrotic lesions.…”

“…Feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) is a recently described eosinophilic nodular mass located within the gastrointestinal tract (Craig et al 2009;Linton et al 2015). Although a few studies and case reports have been reported on FGESF, computed tomography (CT) features are limited to the extramural retroperitoneal area and rectum (Thieme et al 2019;Goffart et al 2022). A recent study on FGESF reported ul-trasonographic findings in 30 cats, revealing typical features such as a loss of intestinal layering, thickening, and mixed wall echogenicity with hyperechoic areas, particularly in gastric or intestinal cases (Cerna et al 2024).…”

Intrathoracic eosinophilic sclerosing fibroplasia with intralesional bacteria in a cat

“…1,9,12,13 A multimodal approach is currently recommended with a combination of debulking surgery, when possible, together with antimicrobial and immunosuppressive therapy (prednisolone with or without ciclosporine). 1,9,10,[12][13][14] Despite adopting this multimodal approach, in the case reported here, death occurred only 2 months after diagnosis. The cause remained undetermined.…”

“…This is likely because of an earlier diagnosis as a result of increased awareness, as well as improved understanding of the pathogenesis of the condition resulting in more appropriate management. 1,9,12,13 A multimodal approach is currently recommended with a combination of debulking surgery, when possible, together with antimicrobial and immunosuppressive therapy (prednisolone with or without ciclosporine). 1,9,10,[12][13][14] Despite adopting this multimodal approach, in the case reported here, death occurred only 2 months after diagnosis.…”

“…Feline eosinophilic sclerosing fibroplasia (FESF) is an emerging clinical entity, 1 with 53 cases reported since its first official characterisation in 2009. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Most cases manifest as masses confined to the gastrointestinal tract (GIT), with possible mesenteric lymph node involvement. 2,3,5 Rarely, the liver, pancreas and sternal or mediastinal lymph nodes are concurrently affected.…”