Antemortem diagnosis of cholangiocellular carcinoma in a horse.

This research article reports on a case of a 10-year-old horse that was diagnosed with metastatic cholangiocellular carcinoma, a type of liver cancer. The horse showed various symptoms such as fever, lethargy, and anorexia and despite treatment did not show improvement, leading to its euthanasia.

Initial Symptoms and Tests

• The horse was presented with intermittent fever, lethargy, and anorexia. These symptoms led to its admission to the veterinary teaching hospital.
• Initial lab tests, including blood tests, showed the horse had anemia and hyperfibrinogenemia, meaning it had a high level of fibrinogen in the blood, indicative of inflammation or a significant infection.
• Abdominocentesis and thoracentesis were performed to collect fluid samples from the abdomen and chest. Both samples showed high counts of nucleated cells and high concentrations of protein, leading to a tentative diagnosis of nonseptic peritonitis, an inflammation of the peritoneum that is not caused by an infection.

Further Symptoms and Diagnosis

• Despite treatment with antibiotics, the horse did not improve. It showed a new symptom of pitting edema of the ventral midline, suggesting some form of systemic disease.
• Additional imaging tests including thoracic radiography and ultrasonography revealed consolidation in the lungs and pleural effusion, a condition where excess fluid builds up in the space between the lungs and the chest cavity.
• Pleuroscopy, a procedure to visually examine the pleural space, revealed a mass in the mediastinum, the region between the lungs.
• The liver and the mediastinal mass were biopsied, and the findings led to a presumptive diagnosis of metastatic cholangiocellular carcinoma, a type of liver cancer that had spread to other parts of the body.

Conclusion and Necropsy

• Due to the severity of the horse’s condition, it was euthanized. A postmortem examination or necropsy was performed to confirm the diagnosis.
• The necropsy confirmed the presence of metastatic cholangiocellular carcinoma, validating the antemortem diagnosis.

This case demonstrates the importance of thorough investigation when presented with a complex of symptoms, demonstrating how a combination of various tests can lead to a final diagnosis.