Primary Lumbar Extradural Hemangiosarcoma in a Dog

Malignant transformation of an intraparenchymal hemangioma in the cervical spinal cord of a German shepherd dog

An 8-year-old female spayed German shepherd dog was presented for evaluation of a 1-week history of right thoracic limb monoparesis. Magnetic resonance imaging (MRI) identified an intraparenchymal, T2 hypointense and T1 isointense, strongly heterogeneously contrast-enhancing mass with moderate internal susceptibility artifact on T2* images at the level of the cranial extent of the C5 vertebral body. Euthanasia was elected after a rapid neurologic decline in the 24 hours after MRI. Necropsy and histopathology identified an intraparenchymal hemangiosarcoma arising from a hemangioma in the cervical spinal cord, with no evidence of neoplastic disease in any other examined organs. The spectrum of vasoproliferative disorders in the central nervous system in veterinary species has been codified recently, but hemangiosarcoma is considered metastatic to the central nervous system. Herein we describe the clinical, imaging, and histologic findings in a dog with a novel primary location of hemangiosarcoma in the cervical spinal cord.

Spinal cord haemangiosarcoma in one dog - Case report

A 5-year-old intact female Shih Tzu was presented with acute onset of hind leg paralysis. The neurologic examination revealed severe T3-L3 myelopathy. The differential diagnoses included degenerative, anomalous, traumatic, inflammatory, vascular, metabolic, and neoplastic changes. The results of the paraclinical examinations and diagnostic imaging narrowed the list of differential diagnoses and, along with the patient's deteriorating condition, led to the owner's decision to euthanise the dog. The histologic findings of the spinal cord specimens indicated a tumour of the blood vessels formed by the proliferation of endothelial cells, which may present as either capillary or cavernous structures. In this case, the tumour was a capillary-type haemangiosarcoma. The primary site of proliferation could not be determined in this case because no mass formation was noted while performing the necropsy.

MRI features of canine hemangiosarcoma affecting the central nervous system

Hemangiosarcoma is the most common metastatic tumor involving the brain in dogs but detailed published descriptions of the magnetic resonance imaging (MRI) features are lacking. The objective of this multi-center, retrospective case series study was to describe MRI characteristics of canine hemangiosarcoma affecting the central nervous system (CNS). Medical records of seven referral institutions were retrospectively reviewed. Dogs were included if they had a histopathologically confirmed diagnosis of hemangiosarcoma affecting the CNS and undergone an MRI of the brain and/or vertebral column. Lesions were independently evaluated by two observers. Twenty dogs met the inclusion criteria and one dog had both intracranial and intramedullary hemangiosarcoma. Consistent MRI features included heterogeneous (17/21) lesions in all sequences with mainly mixed signal intensity (12/21), presence of susceptibility artifact on T2*w (15/16), associated moderate to severe perilesional edema (21/21), and moderate to strong (20/21) heterogeneous (14/21) or ring-like (6/21) contrast enhancement. Intracranial hemangiosarcoma was frequently multiple and intra-axial, affecting consistently the telencephalon and no differences in MRI features were found between primary and metastatic hemangiosarcoma. This is the first MRI description of primary intracranial hemangiosarcoma and primary intracranial epithelioid hemangiosarcoma. Vertebral hemangiosarcomas were segmental poorly marginated polyostotic and highly aggressive lesions invading the thoracic vertebral canal and paraspinal tissues. Epidural hemangiosarcomas were single and well-marginated lesions in the thoracolumbar and/or lumbar region. Intramedullary hemangiosarcomas were cervical, metastatic in origin, and frequently (3/4) accompanied by intracranial lesions. These described MRI features will aid early identification of hemangiosarcoma guiding subsequent diagnostics and therapeutics.

Canine and feline haemangiosarcoma

INTRODUCTION

Haemangiosarcoma (HSA) is a malignant neoplasm of dogs and cats that is suspected to originate from a pluripotent bone marrow progenitor with a complex and multifactorial pathogenesis.

APPROACH

Pertinent literature was identified, reviewed, and summarized for inclusion in the manuscript.

RESULTS/INTERPRETATION

Dogs are more frequently diagnosed with HSA than cats, and primary sites of this disease include dermal, subcutaneous/intramuscular, and visceral (most commonly the spleen). Dogs and cats with HSA generally have a poor prognosis owing to the rapid and widespread metastasis typically associated with this disease. However, some forms such as cutaneous HSA behave in a less aggressive fashion with improved outcomes. Surgical excision and anthracycline-based chemotherapy remain the mainstays of treatment, although novel treatment modalities are currently under investigation for potential roles in treatment of this disease.

CONCLUSION

This review aims to describe the clinical presentation and progression of the various forms of HSA in dogs and cats as well as to provide a systematic review of the veterinary literature with a focus on the various published treatment options and associated outcomes.

Magnetic Resonance Imaging Features of Extradural Spinal Neoplasia in 60 Dogs and Seven Cats

This retrospective study describes the MRI features of extradural spinal neoplasia in 60 dogs and seven cats to identify potential distinguishing features between tumor classes and individual tumor types within each class. In dogs, mesenchymal tumors were most common (48%), with undifferentiated sarcomas being the predominant tumor type. Round cell neoplasms were second most common (35%), with lymphoma and multiple myeloma/plasma cell tumor comprising the majority of cases. Only two benign tumors were identified. In cats, lymphoma was most common (5/7), with one case of mesenchymal neoplasia and one case of metastatic carcinoma. Despite some overlap, certain imaging features were able to help prioritize differential diagnoses. The combined features that predicted round cell neoplasia (84%) included the preservation of vertebral shape, homogeneous contrast enhancement, and lesion centering on bone. The combined features that predicted mesenchymal neoplasia (73%) included altered vertebral shape, heterogeneous contrast enhancement, and lesion centering on paraspinal soft tissues. Round cell neoplasms were more likely to have cortical sparing, preservation of overall shape, lesion centering on bone, small soft tissue tumor size, and homogeneous contrast enhancement. Both epithelial and mesenchymal neoplasms were more likely to have cortical lysis, a cavitary component to the soft tissue mass and medium to large soft tissue mass size. The findings of this study can aid in prioritizing differential diagnoses in cases of extradural spinal neoplasia in cats and dogs, which can impact case management, but tissue sampling remains the gold standard for definitive diagnosis.

A Review of Proliferative Vascular Disorders of the Central Nervous System of Animals

In disease, blood vessel proliferation has many salient roles including in inflammation, when granulation tissue fills superficial defects, or in the recanalization of an occluded blood vessel. Sometimes angiogenesis goes awry-granulation can be exuberant, and plexiform proliferation of vascular components can contribute to pulmonary hypertension. This review focuses on the diverse manifestations of pathologic vascular overgrowth that occur in the brain, spinal cord, and meninges of animals from birth until old age. Entities discussed include systemic reactive angioendotheliomatosis in which glomeruloid vascular proliferations are encountered in various organs including the central nervous system (CNS). The triad of CNS vascular malformations, hamartomas, and benign vascular proliferations are an especially fraught category in which terminology overlap and the microscopic similarity of various disorders makes diagnostic classification incredibly challenging. Pathologists commonly take refuge in "CNS vascular hamartoma" despite the lack of any unique histopathologic features and we recommend that this diagnostic category be abandoned. Malformative lesions that are often confusing and have similar features; the conditions include arteriovenous malformation, cavernous angioma, venous angioma, and capillary telangiectases. Meningioangiomatosis, a benign meningovascular proliferation with dual components, is a unique entity seen most commonly in young dogs. Last, accepted neoplastic conditions range from lower-grade locally acquired growths like hemangioblastoma (a tumor of mysterious interstitial stromal cells encountered in the setting of abundant capillary vasculature proliferation), the rare hemangioendothelioma, and the highly malignant and invariably multifocal metastatic hemangiosarcoma. Additionally, this review draws on the comparative medical literature for further insights into this problematic topic in pathology.

Primary Hemangiosarcoma of the Falciform Fat in Seven Dogs (2007-2015)

Canine hemangiosarcoma (HSA), a malignant neoplasm of vascular endothelial or bone marrow progenitor cell origin, most often affects the spleen, heart, and liver and typically has an aggressive biologic behavior. Canine HSA arising from the falciform fat/ligament represents a rare anatomic variant, with only two reports in the veterinary literature. In this study, we describe the clinical presentation, treatment, and outcome of seven dogs with primary HSA of the falciform ligament. Histologic grade and mitotic score were not significantly associated with outcome. All dogs had the primary tumor surgically excised except for one diagnosed at necropsy. Median overall survival for all dogs diagnosed prior to necropsy was 339 days, and the 1 yr survival rate was 50%. Four dogs were treated with adjuvant chemotherapy and had a significantly longer median overall survival (394 versus 83 days) than those that did not (P = .018). Dogs with HSA of the falciform ligament may have improved 1 yr survival rates and longer median survival time compared with dogs with HSA in more common visceral locations.