Hepatocellular carcinoma in a green iguana – a case study

A 3.10 kg, six-year old male green iguana (Iguana iguana) suffered several weeks of decreased activity, loss of body weight, anorexia and change of skin colour. Physical examination revealed a cachectic depressed lizard, with marked pale mucous membranes. The complete blood count revealed a leukocytosis (46.5 × 109/l), elevated heterophils (23.25 × 109/l) and azurophils (23.25 × 109/l), decreased haemoglobin concentration (29.00 g/l), low haematocrit (0.16 l/l) and erythropenia (0.35 × 1012/l). Abnormalities of the plasma chemistry panel included increased activity of aspartate aminotransferase (6.05 μkat/l) and creatinephosphokinase (217.91 μkat/l), increased concentrations of uric acid (321.58 μmol/l), phosphorus (4.04 mmol/l) and bile acids (120.21 μmol/l), as well as a decreased concentration of glucose (3.72 mmol/l), cholesterol (0.637 mmol/l) and triglycerides (0.09 mmol/l). A lateral radiograph revealed soft-tissue opacity present in the region of the liver. Magnetic resonance imaging showed a markedly enlarged left liver lobe distended caudally and displacing the other abdominal organs. The signal intensity of the liver parenchyma was slightly hyperintense, the ventro-medial part of the left lobe showed a hypointense signal. Endoscopic examination of the coelomic cavity revealed a greatly enlarged pale liver and the presence of a straw-coloured modified transudate. Based on histopathological examination of the liver hepatocellular carcinoma was diagnosed. Despite supportive treatment the patient died on the sixth day of hospitalisation