# Diagnostic Approach and Pathological Characterization of Metastatic Intrahepatic Cholangiocarcinoma in a Captive Puma (Puma concolor)

## TL;DR

A puma with liver cancer and widespread metastasis was diagnosed using clinical, imaging, and pathological methods, highlighting the need for collaborative diagnosis in captive wildlife.

## Contribution

This case report provides insights into diagnosing and characterizing metastatic intrahepatic cholangiocarcinoma in a captive puma through a multidisciplinary approach.

## Key findings

- The puma had intrahepatic cholangiocarcinoma with metastases to multiple organs.
- Histological and immunohistochemical analysis confirmed the tumor's characteristics.
- The case emphasizes the importance of integrated clinical and pathological evaluation in wildlife.

## Abstract

This report describes a case of intrahepatic cholangiocarcinoma with disseminated metastasis in a 16-year-old captive puma, highlighting the value of a comprehensive, multidisciplinary approach. It underscores the importance of clinical, diagnostic, and pathological collaboration in fully understanding the disease. The case provides important insights for veterinarians, pathologists, and wildlife specialists, emphasizing the need for integrated efforts in diagnosing and managing complex conditions in large felids under human care.

A 16-year-old captive male puma (Puma concolor) presented with progressive weight loss and acute mild gastrointestinal symptoms. Clinical examination, and diagnostic imaging revealed abdominal, pleural, and pericardial effusion and nodular masses in multiple organs. Due to the clinical condition, multiple organ involvement, and a poor prognosis, compassionate euthanasia was chosen. Necropsy revealed abundant cavitary effusions and multiple yellow–white neoplastic masses involving the left hepatic lobes. Metastatic nodules were observed throughout the peritoneum, pericardium, kidney, spleen, and spermatic cord. Histologically, the tumor was characterized by tubular and acinar structures embedded in a desmoplastic stroma. Neoplastic cells were positive for pan-cytokeratins (CKs), CK7, and, to a lesser extent, CK20. The gross, histologic, and immunohistochemical findings were consistent with intrahepatic metastatic cholangiocarcinoma.