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

Area of Science:

• Veterinary Medicine
• Surgical Oncology
• Comparative Pathology

Background:

• Peritoneopericardial diaphragmatic hernia (PPDH) is a congenital defect involving abdominal organs protruding into the thoracic cavity through the diaphragm.
• Cardiac tamponade, a life-threatening condition caused by fluid accumulation around the heart, is a known complication of various thoracic diseases.

Observation:

• A cat presented with dyspnea and suspected pleural effusion, revealing a large pericardial effusion causing cardiac tamponade via ultrasonography.
• Computed tomography (CT) identified a PPDH with herniated liver lobes and an associated cystic hepatic mass.
• Surgical intervention included herniorrhaphy, partial pericardiectomy, and lobectomy of the incarcerated liver mass.

Findings:

• Histopathology confirmed a poorly differentiated hepatic sarcoma within the incarcerated liver lobe.
• The cat developed metastatic sarcoma two months post-surgery, leading to euthanasia.
• This case represents a previously unreported sequela of PPDH in cats: pericardial effusion causing cardiac tamponade.

Implications:

• The findings suggest that PPDH should be considered in cats presenting with unexplained pericardial effusion and cardiac tamponade.
• Malignancy within incarcerated liver lobes, particularly sarcomas in atypical locations, warrants further investigation.
• This case expands the understanding of PPDH complications and the potential for hepatic sarcomas in feline patients.