Haemangiosarcoma
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Description
A highly malignant tumour of vascular endothelial origin. They 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.
Signalment
Often found in older German Shepherd Dogs and Golden Retrievers. Domestic Short haired cats are the most commonly affected cat breed.
Golden RetrieverMonika Mężyńska (2005); WikiMedia Commons
German Shepherd (Alsatian)Ellen Levy Finch (22/02/04); WikiMedia Commons
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; due to rupture of the mass, leading to a haemoabdomen or occasionally be found dead.
In instances where the heart is involved animals may present in heart failure. If there is muscularinvolvement 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; 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 also 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 was 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.
Pathology
Cholangiocellular - bile duct
From Spleen Pathology
distinguished from the superficially similar haemangioma by the presence of much more formed, solid tumour tissue
- accurate prognosis demands histological examination
- secondaries are common locally in the omentum and in the liver
The course of disease is usually short, often only a month or two and metastases may occur in almost every organ.
Treatment
Surgery
This is useful if there are any solitary masses that can be excised.
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.