Difference between revisions of "Haemangiosarcoma"

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==Introduction==
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A highly malignant tumour of vascular endothelial origin. Commonly affect dogs and the most frequently affected areas are the spleen, pericardium, right atrium, liver and muscle.  The cat is affected less frequently and the most common sites are the liver, spleen and mesentry. Metastasis occurs via the haematogenous route or via rupture and transabdominal spread.  Metastatic sites include, lungs, liver, omentum, diaphragm and less commonly brain. Surgery is the treatment of choice but even with this survival time remains very short.
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==Description==
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A highly malignant tumour of vascular endothelial origin. Commonly affect dogs and the most frequently affected areas are the spleen, pericardium, right atrium, liver and muscle.  The cat is affected less frequently and the most common sites are the liver, spleen and mesentry. Metastasis occurs via the haematogenous route or via rupture and transabdominal spread.  Metastatic sites include, lungs, liver, omentum and diaphram. Surgery is the treatment of choice but even with this survival time remains very short.
  
 
==Signalment==
 
==Signalment==
 
Often found in German Shepherd Dogs and Golden Retrievers over 9 years of age. Domestic Short haired cats are the most commonly affected cat breed.
 
Often found in German Shepherd Dogs and Golden Retrievers over 9 years of age. Domestic Short haired cats are the most commonly affected cat breed.
  
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<gallery>
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Image:Golden-retriever.jpg|'''Golden Retriever''' <p> Monika Mężyńska (2005); WikiMedia Commons
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Image:GermanShep.jpg|'''German Shepherd (Alsatian)''' <p> Ellen Levy Finch (22/02/04); WikiMedia Commons
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</gallery>
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==Diagnosis==
 
==History and Clinical Signs==
 
==History and Clinical Signs==
 
Can vary depending on the anatomic site that the mass is affecting.
 
Can vary depending on the anatomic site that the mass is affecting.
Signs such as anorexia, lethargy, weakness, [[vomiting]] and [[Regenerative and Non-Regenerative Anaemias|anaemia]] are common.
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Signs such as anorexia, lethargy, weakness, vomiting and anaemia are common.
Animals may have history of multiple episodes of collapse following repeated rupture of an abdominal mass, leading to non-fatal haemoabdomen. Occasionally can be found dead following catastrophic rupture and fatal haemoabdmen.  
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Animals can also present Collapsed following the rupture of the mass, leading to a haemoabdomen or occasionally can be found dead.  
  
In instances where the heart (right auricle) is involved, animals may die suddenly or present in [[:Category:heart Failure|heart failure]]. Rupture of the mass and haemorrhage into the pericardial sac leads to compression of the heart, which can no longer fill with blood during diastole ([[Cardiac Tamponade|cardiac tamponade]]).
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In instances where the heart is involved animals may present in heart failure. If there is muscular involvement this often presents as a hard swollen mass.
  
If the nervous system is involved a range of neurological abnormalities will also be present.
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If the nervous sytem is involved a range of neurological abnormalities will also be present.
  
 
==Laboratory Tests==
 
==Laboratory Tests==
 
====Haematology====
 
====Haematology====
Anaemia will be evident which may be [[Regenerative and Non-Regenerative Anaemias|regenerative]] if due to blood loss, or microangiopathic due to the passage of [[erythrocytes|red blood cells]] through the microvascular network of the tumour.
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Anaemia will be evident which may be regenerative if due to blood loss, or microangiopathic due to the passage of red blood cells through the microvascular network of the tumour.
 
This results in the presence of schistocytes in dogs but not cats.
 
This results in the presence of schistocytes in dogs but not cats.
 
A [[Neutrophilia|neutrophilia]] and [[Platelet Abnormalities#Thrombocytopaenia|thrombocytopenia]] may also be present.
 
A [[Neutrophilia|neutrophilia]] and [[Platelet Abnormalities#Thrombocytopaenia|thrombocytopenia]] may also be present.
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===Ultrasonography===
 
===Ultrasonography===
This is sensitive in identifying liver and splenic masses where the spleen will show a mixed or non-homogenoeous pattern and the liver will look hypoechoic or anechoic. It can also be useful to detect metastatic spread.
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This is sensitive in indentifying liver and splenic masses where the spleen will show a mixed or nonhomogenoeous pattern and the liver will look hypoechoic or anechoic. It can also be useful to detect metastatic spread.
  
 
==Biopsy==
 
==Biopsy==
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==Treatment==
 
==Treatment==
 
===Surgery===
 
===Surgery===
Surgery is the treatment of choice for haemangiosarcoma in the dog and cat. All diseased tissue should be removed and splenic haemangiosarcoma should be treated via splenectomy. Local removal is difficult if the pericardium and right atrium is involved. A pericardectomy can be undertaken but the prognosis with tumours at this location is grave.
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Surgery is the treatment of choice for haemangiosarcoma in the dog and cat. All diseased tissue should be removed. Splenic haemangiosarcoma should be treated via splenectomy. Local removal is difficult if the pericardium and right atrium is involved. A pericardectomy can be undertaken but the prognosis with tumours at this location is grave.
  
 
===Chemotherapy===
 
===Chemotherapy===
 
This will provide a palliative treatment for animals with multiple masses or as an adjuvant therapy post-operatively.
 
This will provide a palliative treatment for animals with multiple masses or as an adjuvant therapy post-operatively.
Doxorubicin based products are the most commonly used drugs for haemangiosarcomas.
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==Prognosis==
 
==Prognosis==
 
Poor due to high risk of metastasis in the early course of the disease.
 
Poor due to high risk of metastasis in the early course of the disease.
  
{{Learning
 
|Vetstream = [https://www.vetstream.com/canis/Content/Disease/dis01993.asp Haemangiosarcoma]
 
|flashcards = [[Liver_Flashcards_-_Pathology|Liver Pathology Flashcards]]
 
|literature search = [http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=Haemangiosarcoma&occuring1=title&rowId=2&options2=AND&q2=&occuring2=freetext&rowId=3&options3=AND&q3=&occuring3=freetext&x=55&y=10&publishedstart=yyyy&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Haemangiosarcoma]
 
|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2010/20103181324.pdf ''' A review and what's new in canine hemangiosarcoma.''' Garrett, L. D.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Orlando, Florida, USA, 16-20 January 2010, 2010, pp 956-959]
 
}}
 
  
 
==References==
 
==References==
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{{review}}
 
  
{{OpenPages}}
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[[Category:Liver,_Primary_Tumours]]
[[Category:Liver,_Primary_Tumours]][[Category:Cardiac Diseases - Dog]][[Category:Lymphoreticular and Haematopoietic Diseases - Dog]][[Category:Peritoneal Cavity Diseases - Dog]][[Category:Cardiac Diseases - Cat]][[Category:Lymphoreticular and Haematopoietic Diseases - Cat]][[Category:Peritoneal Cavity Diseases - Cat]]
 
 
[[Category:Peritoneal_Cavity_-_Neoplastic_Pathology]]
 
[[Category:Peritoneal_Cavity_-_Neoplastic_Pathology]]
 
[[Category:Neoplasia]][[Category:Splenic Neoplasia]]
 
[[Category:Neoplasia]][[Category:Splenic Neoplasia]]
 
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[[Category:To Do - Caz]]
[[Category:Expert_Review]]
 
[[Category:Cardiology Section]]
 

Revision as of 18:00, 18 August 2010




Description

A highly malignant tumour of vascular endothelial origin. Commonly affect dogs and the most frequently affected areas are the spleen, pericardium, right atrium, liver and muscle. The cat is affected less frequently and the most common sites are the liver, spleen and mesentry. Metastasis occurs via the haematogenous route or via rupture and transabdominal spread. Metastatic sites include, lungs, liver, omentum and diaphram. Surgery is the treatment of choice but even with this survival time remains very short.

Signalment

Often found in German Shepherd Dogs and Golden Retrievers over 9 years of age. Domestic Short haired cats are the most commonly affected cat breed.

Diagnosis

History and Clinical Signs

Can vary depending on the anatomic site that the mass is affecting. Signs such as anorexia, lethargy, weakness, vomiting and anaemia are common. Animals can also present Collapsed following the rupture of the mass, leading to a haemoabdomen or occasionally can be found dead.

In instances where the heart is involved animals may present in heart failure. If there is muscular involvement this often presents as a hard swollen mass.

If the nervous sytem is involved a range of neurological abnormalities will also be present.

Laboratory Tests

Haematology

Anaemia will be evident which may be regenerative if due to blood loss, or microangiopathic due to the passage of red blood cells through the microvascular network of the tumour. This results in the presence of schistocytes in dogs but not cats. A neutrophilia and thrombocytopenia may also be present.

Diagnostic Imaging

Radiography

Useful to look for evidence of metastasis.

Ultrasonography

This is sensitive in indentifying liver and splenic masses where the spleen will show a mixed or nonhomogenoeous pattern and the liver will look hypoechoic or anechoic. It can also be useful to detect metastatic spread.

Biopsy

The only way to to form a definitive diagnosis is following a biopsy and histopathology. This is needed to differentiate haemangiosarcoma from splenic haematoma, haemangioma and accessory splenic tissue.

Treatment

Surgery

Surgery is the treatment of choice for haemangiosarcoma in the dog and cat. All diseased tissue should be removed. Splenic haemangiosarcoma should be treated via splenectomy. Local removal is difficult if the pericardium and right atrium is involved. A pericardectomy can be undertaken but the prognosis with tumours at this location is grave.

Chemotherapy

This will provide a palliative treatment for animals with multiple masses or as an adjuvant therapy post-operatively.


Prognosis

Poor due to high risk of metastasis in the early course of the disease.


References

Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company.

Hall, E.J, Simpson, J.W. and Williams, D.A. (2005) BSAVA Manual of Canine and Feline Gastroenterology (2nd Edition) BSAVA

Nelson, R.W. and Couto, C.G. (2009) Small Animal Internal Medicine (Fourth Edition) Mosby Elsevier.