Nasal adenocarcinoma as a suspected secondary malignant neoplasm in a cat previously treated for nasal lymphoma

Case summary

A case of nasal adenocarcinoma as a suspected secondary malignant neoplasm following definitive radiation therapy and multiagent chemotherapy for nasal lymphoma is described. An 11-year-old spayed female domestic shorthair cat was presented for a 3-week history of progressive facial swelling located over the nasal planum and extending to the medial canthus of the right eye. The cat was previously diagnosed with nasal lymphoma and treated with chemotherapy and definitive radiation 2.5 years prior. Although a definitive diagnosis could not be obtained via cytology, recurrent lymphoma was suspected based on the cat’s history and recurrent clinical signs. A lymphoma-directed chemotherapy protocol was attempted, but no clinical response was achieved. The cat was euthanased owing to progressive clinical signs and a diagnosis of nasal adenocarcinoma was made on necropsy examination. Both the original diagnosis of nasal lymphoma and the secondary diagnosis of nasal adenocarcinoma were confirmed with immunohistochemistry.

Relevance and novel information

Secondary malignant neoplasm following radiation therapy is infrequently reported in the veterinary literature. In the few reports that exist, most have described sarcoma development in the dog following radiation therapy. In the present report, we describe a cat with a suspected radiation-induced nasal adenocarcinoma that developed 2.5 years after definitive radiation treatment for nasal lymphoma.

Malignant Tumor Formation in Dogs Previously Irradiated for Acanthomatous Epulis

In this retrospective study of 57 dogs irradiated for oral acanthomatous epulis, 2 (3.5%) dogs developed a second tumor (sarcoma, osteosarcoma) in the radiation treatment field at 5.2 and 8.7 years after the end of radiation therapy. As opposed to previous reports, no second epithelial tumors developed in the radiation treatment field. There is a risk of radiation-induced carcinogenesis, but it appears that it is a relatively low risk and an event that occurs years after radiation therapy. Radiation-induced tumors are of more concern in younger dogs that undergo radiation therapy for tumors that are radioresponsive, such as acanthomatous epulis, where long-term survival is expected. The only statistically significant variable in the survival analysis was age, with dogs less than 8.3 years old having a significantly longer median overall survival (2322 days) than dogs older than 8.3 years (1106 days; P<0.0001).

Radiation induced vertebral osteosarcoma following treatment of an intradural extramedullary spinal cord tumor in a dog

A 2-year-old neutered female Rottweiler diagnosed with an intradural extramedullary spinal cord tumor at T12-T13 was successfully treated with cytoreductive surgery followed by Cobalt 60 teletherapy. The dog was euthanised 5-and-a-half years later following diagnosis of an osteosarcoma involving the L1 and L2 vertebrae. Evidence of the initial tumor was not present at necropsy. The vertebral neoplasm fulfilled all of the accepted criteria for a radiation induced tumor. It was concluded that adjunctive irradiation should be considered for treatment of intradural extramedullary tumors of young dogs when total surgical resection is not possible. Although tumor induction is a rare late effect of radiation therapy, the risk of this occurrence should be considered when irradiating young animals. Radiation induced tumors in dogs have been associated with coarse fractionation schemes, or when large intraoperative doses have been administered. A lower dose per fraction, e.g., 3 Gy/fraction or less, is advisable when irradiating young dogs or any dog in which the life expectancy is 3-5 or more years after irradiation.

Canine axial skeletal osteosarcoma. A retrospective study of 116 cases (1986 to 1989)

Axial skeletal osteosarcomas were evaluated retrospectively in 116 dogs. Thirty-one tumors occurred in the mandible, 26 in the maxilla, 17 in the spine, 14 in the cranium, 12 in the ribs, 10 in the nasal cavity and paranasal sinuses, and 6 in the pelvis. Medium-sized and large dogs were most commonly affected. Females outnumbered males 2.1:1, but this varied with tumor location. The mean age was 8.7 years. Osteosarcomas of the rib occurred in significantly younger dogs (mean age, 5.4 years) than osteosarcomas at any other axial skeletal site. Pulmonary metastasis was diagnosed radiographically in 11.1% of the dogs. The median survival for dogs treated surgically was 22 weeks, the 1-year survival was 26.3%, and the 2-year survival was 18.4%. The tumor recurrence rate was 66.7%. Most dogs (79.6%) died or were euthanatized for problems associated with the primary tumor.

Canine extraskeletal osteosarcoma and chondrosarcoma: a clinicopathologic study of 14 cases

Canine extraskeletal osteosarcomas are extremely rare tumors. Over a period of 25 years at the Animal Medical Center, approximately 1,000 cases of skeletal osteosarcomas have been diagnosed. During the same period 11 cases of extraskeletal osteosarcomas and three extraskeletal chondrosarcomas were diagnosed. Tumors of the mammary gland were excluded. Extraskeletal osteosarcomas were found in the adrenal gland, eye, gastric ligament, ileum, kidney, liver, spleen, testicle, and vagina. The chondrosarcomas were found in the mitral valves, lungs, and omentum. The mean age of the dogs with extraskeletal osteosarcoma was 11 years, and the mean age of the dogs with extraskeletal chondrosarcoma was 14 years. The The sizes of the tumors ranged from 3 cubic centimeters to 8,315 cubic centimeters. Osteoblastic osteosarcomas were the most common histologic type (7/11, 63.6%); there was a single case of each of the following: fibroblastic, fibrous histiocytic, chondroblastic, and mixed osteo-chondroblastic osteosarcoma. Two of the dogs with chondrosarcomas had mesenchymal chondrosarcomas involving the lungs and omentum. The remaining dog had a regular chondrosarcoma involving the mitral valve. Distant metastases were present in seven of 11 dogs with extraskeletal osteosarcoma and in none of the dogs with chondrosarcoma. In contrast to human beings, in which most extraskeletal osteosarcomas occur in the soft tissues and the extremities, most canine extraskeletal osteosarcomas develop in the visceral organs.