Lateral manus translation for limb-sparing surgery in 18 dogs with distal radial osteosarcoma in dogs

Updates in Surgical Oncology

New knowledge and data can influence the treatment options of dogs and cats affected by neoplasms. Partial limb amputation with the use of a prosthesis is possible in dogs. Newer studies attempt to define better and understand the complications and limb function associated with this approach. Limb sparing is an alternative to amputation, and three-dimensional printing allows the manufacturing of personalized endoprostheses. Finally, the recommended approach for the excision of cutaneous mast cell tumors (MCTs) is with proportional margins. In dogs, grade shifting might have occurred when removing a recurrent MCT or soft tissue sarcoma.

Case report: Limb-sparing surgery of tibial chondrosarcoma with frozen autologous bone graft using liquid nitrogen in a dog

Chondrosarcoma is the second most common primary bone tumor after osteosarcoma in dogs. Chondrosarcoma has a good prognosis owing to its low metastatic rate and long survival time, even with amputation alone. However, amputation risks reducing the quality of life in patients with other orthopedic diseases of the non-affected limb, neurological diseases, or large body size. Limb-sparing surgery with frozen autologous bone grafting using liquid nitrogen allows bone quality to be maintained in the normal bone area while killing tumor cells, thereby preserving the affected limb. Thus, it is expected to maintain the quality of life. We describe herein limb-sparing surgery for tibial chondrosarcoma with frozen autologous bone graft using liquid nitrogen in an 8-year and 8-month-old castrated male bulldog weighing 29.2 kg. The patient had chondrosarcoma of the left tibia, suspected cranial cruciate ligament rupture of the right stifle, and degenerative lumbosacral stenosis. In such a case, amputation would increase the burden on the non-affected limb or spine, which could cause difficulty in walking; therefore, we performed limb-sparing surgery. Postoperatively, although a circumduction gait associated with stifle arthrodesis remained, the patient maintained the quality of life for 20 months, and the owner was satisfied with the results.

Iliectomy with limb preservation for a dog with ilial osteosarcoma: Surgical description and case report

OBJECTIVE

To report the surgical technique for iliectomy and outcome in a single clinical case.

STUDY DESIGN

Case report.

ANIMAL

A 10-year-old female spayed Rottweiler.

METHODS

A dog presented with left pelvic limb lameness due to a mass involving the left ilium. Fine needle aspirates were indicative of a sarcoma and suspicious for osteosarcoma. Computed tomography of thorax, abdomen, and pelvis was performed as well as skeletal scintigraphy, with no evidence of metastasis seen. The dog underwent iliectomy with preservation of the ipsilateral limb and was ambulatory 24 hours after surgery. Results of histopathology confirmed the diagnosis of an osteosarcoma.

RESULTS

A right ischial fracture was noted 8 days postoperatively and was conservatively managed. Local recurrence was reported 385 days postoperatively, with no overt metastatic disease revealed by computed tomography of the thorax and abdomen. The dog was euthanized because of local recurrence 430 days after surgery.

CONCLUSION

Iliectomy was well tolerated in this dog and afforded good function of the pelvic limbs. Local recurrence developed with no evidence of metastasis at the last follow-up. Iliectomy can be considered for a mass confined to the ilium when preservation of the limb is desired. Additional studies are required to determine the local recurrence and complication rates associated with this procedure in dogs with axial skeletal osteosarcoma.

CLINICAL SIGNIFICANCE

To the authors' knowledge, this case report represents the fist surgical description and clinical outcome for an iliectomy in dogs.

Limb-sparing in dogs using patient-specific, three-dimensional-printed endoprosthesis for distal radial osteosarcoma: A pilot study

Limb-sparing for distal radial osteosarcoma has a high rate of complications. Using personalized three-dimensional (3D)-printed implants might improve outcome. The goals of this study were to optimize use of patient-specific, 3D-printed endoprostheses for limb-sparing in dogs in the clinical environment and to report the outcome. This was a pilot study where five client-owned dogs were enrolled. Computed tomography (CT) of the thoracic limbs was performed, which was used to create patient-specific endoprostheses and cutting guides, and repeated on the day of surgery. Intra-arterial (IA) carboplatin was introduced in the clinical management. Limb-sparing was performed. Outcome measures were time required to produce the endoprosthesis and cutting guide, fit between cutting guide and endoprosthesis with host bones, gait analysis, size of the tumour, percent tumour necrosis, complications, disease-free interval (DFI) and survival time (ST). Four dogs received IA carboplatin. Excessive tumour growth between planning CT and surgery did not occur in any dog. The interval between the CT and surgery ranged from 14 to 70 days. Fit between the cutting-guide and endoprosthesis with the host bones was good to excellent. At least one complication occurred in all dogs. Two dogs were euthanized with STs of 192 and 531 days. The other dogs were alive with a follow up of 534 to 575 days. IA chemotherapy is a promising strategy to minimize the risk of excessive tumour growth while waiting for the endoprosthesis and cutting-guide to be made. The design of the cutting-guide was critical for best fit of the endoprosthesis with host bones.