Time to Play! #16, and the answer is…

Thank you for all your pertinent comments!

The dog was a spayed female (spay performed a long time ago), and therefore it is unlikely related to a post-surgical complication. The lesion was located caudal to the right kidney and as you will see on the answer-video, a CT performed as part of the follow-up demonstrated that this is a fatty structure (with a Hunsfield unit of -60). Several rechecks showed that it did not changed over time, supporting that it is incidental and likely a focal fat necrosis.

Another example is illustrated on the video “Idiopathic Fat Necrosis” available through the 2d edition of the Atlas of Small Animal Ultrasonography, or the PREMIUM videos membership.

This entry was posted by Dominique.

3 thoughts on “Time to Play! #16, and the answer is…

  1. I honestly do not understand why this dog went to CT to identify this potential lesion. Before going to that expense to the owner, a linear transducer should have been adopted and included with the scan. I am sure that Elastography is available to you so that at a click of a button, the stress pattern it produced would have suggested something more benign. This result could have easily been compared to that of the carcinoma if you were still hesitant of it’s nature. Finally there is no Doppler flow information presented to us here. This would have proven itself to be invaluable in making an informed decision. It would have also confirmed that the finding wasn’t clinically significant in any way in this case. Sorry to be critical, I hope that I do not appear to be disrespectful in any way. Thank you for sharing your interesting cases with us,sincerely,Bob.

    • Thank you for sharing your thoughts. Actually, as indicated in the clip, the CT was performed as an oncology follow-up and NOT for evaluating this change. As the dog received radiation therapy, the CT was part of the protocol (done 6 months after the US-and the lesion had not changed in size over several months). I spared you the details as it was beyond the scope of this case but I’m glad you gave me the opportunity to tell you more…The change outlined in the clip would NOT be a good reason to perform a CT scan.
      Also, I placed a color-flow image that did not show any vascularization; you are right, it is useful to know that.
      Bob, could you share your personal experience on elastography, and especially of this type of lesions? Do you have any good reference that could benefit the readers?

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