An incidentaloma at ileal intubation

Prevalence and Features of Incidental Findings in Veterinary Computed Tomography: A Single-Center Six-Years' Experience

Computed tomography (CT) is an advanced imaging technique that may lead to detect "incidentalomas", unexpected asymptomatic lesions found during unrelated examinations. Their clinical meaning and management are not clear for veterinarians, who risk unnecessary investigations that harm the patients. This study is a retrospective analysis that aims to investigate incidentalomas in CT exams and to describe their prevalence, location, types and follow-up, their correlations and associations with the species, breed, sex, and age of patients examined and with the kind and number of sites scanned. The reports of 561 CT scans performed in 512 dogs and 49 cats in a veterinary facility over six years were reviewed and compared to the clinical records of the patients. Eighty incidentalomas were found in 57 dogs and four cats. A significant positive correlation was found in dogs between age and the prevalence of incidentalomas. In dogs, the prevalence of incidentalomas was significantly higher in Boxers and in neck, thoracic, and abdominal scans. Spinal incidentalomas were the most common typologies in dogs. This study can represent a tool that allows clinicians to acquire greater awareness about incidentalomas and to carry out the evidence-based clinical management of them.

[From incidentaloma to secondary discovery]

The term incidentaloma, created in 1982, has spread throughout medical literature. However, there does not seem to be a precise definition to describe what an incidentaloma is. In the initial uses, the word incidentaloma systematically designated a mass that was detected during an imaging examination prescribed for diagnostic purposes unrelated to the reason for carrying out the examination. Naming this mass "incidentaloma" did not give any precision on its nature as it can be located in many anatomical zones, secreting or not, benign or malignant, etc. Today, the term "incidentaloma" carries a much broader dimension which seems to cover the notion of incidental discovery, whether radiological, biological or genetic. The evolution of the term "incidentaloma" demonstrates its heuristic nature. It is a sign of a change in modern medicine which hesitates between a patient clinic and a data clinic. Fortuitous discoveries are a phenomenon known and anticipated by radiologists. Thus, these discoveries are no longer fortuitous, or even unexpected, but secondary to the use of health technology.