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Long-term outcome following surgical and radiation treatment of vertebral angiomatosis in a cat

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  • 1 Department of Surgery, MedVet Medical & Cancer Center for Pets, 300 E Wilson Bridge Rd, Worthington, OH 43085.
  • | 2 Department of Surgery, MedVet Medical & Cancer Center for Pets, 300 E Wilson Bridge Rd, Worthington, OH 43085.
  • | 3 Department of Radiology, MedVet Medical & Cancer Center for Pets, 300 E Wilson Bridge Rd, Worthington, OH 43085.
  • | 4 Idexx Laboratories, 300 E Wilson Bridge Rd, Ste 200, Worthington, OH 43085.
  • | 5 Department of Neurology, MedVet Medical & Cancer Center for Pets, 300 E Wilson Bridge Rd, Worthington, OH 43085.
  • | 6 Department of Rehabilitation, MedVet Medical & Cancer Center for Pets, 300 E Wilson Bridge Rd, Worthington, OH 43085.
  • | 7 Department of Radiation Oncology, MedVet Medical & Cancer Center for Pets, 300 E Wilson Bridge Rd, Worthington, OH 43085.

Abstract

CASE DESCRIPTION A 2-year-old 5.2-kg (11.4-lb) neutered male domestic shorthair cat was referred because of a 6-week history of progressive paraparesis.

CLINICAL FINDINGS Neurologic examination revealed moderate ambulatory paraparesis with marked spinal hyperesthesia at the thoracolumbar junction. The lesion was localized to the T3-L3 spinal cord segment. Clinicopathologic testing, thoracic radiography, and abdominal ultrasonography revealed no abnormalities to explain the observed clinical signs. Advanced spinal imaging with MRI revealed an extradural right-lateralized mass originating from the L2 vertebral pedicle and causing severe spinal cord compression.

TREATMENT AND OUTCOME Surgical decompression was achieved by performance of a right-sided hemilaminectomy at L2. Histologic examination of biopsy samples obtained from the mass revealed an ill-defined zone of mature vascular proliferation extending through the preexisting vertebral bone, consistent with vertebral angiomatosis. After surgical recovery, adjuvant radiation therapy was initiated with a total dose of 48 Gy administered in 16 fractions of 3 Gy each over a 3-week period. Neurologic function rapidly improved to full ambulation with only minimal monoparesis of the right pelvic limb. Results of neurologic and MRI examination performed 26 months after surgery indicated no change in neurologic status or evidence of recurrence.

CLINICAL RELEVANCE To the authors' knowledge, this report was the first to describe the long-term outcome for vertebral angiomatosis in a cat. Surgical decompression and radiation therapy provided an excellent outcome in this case. Vertebral angiomatosis should be considered as a differential diagnosis for any young cat with thoracolumbar myelopathy secondary to a mass associated with the vertebral pedicle.

Abstract

CASE DESCRIPTION A 2-year-old 5.2-kg (11.4-lb) neutered male domestic shorthair cat was referred because of a 6-week history of progressive paraparesis.

CLINICAL FINDINGS Neurologic examination revealed moderate ambulatory paraparesis with marked spinal hyperesthesia at the thoracolumbar junction. The lesion was localized to the T3-L3 spinal cord segment. Clinicopathologic testing, thoracic radiography, and abdominal ultrasonography revealed no abnormalities to explain the observed clinical signs. Advanced spinal imaging with MRI revealed an extradural right-lateralized mass originating from the L2 vertebral pedicle and causing severe spinal cord compression.

TREATMENT AND OUTCOME Surgical decompression was achieved by performance of a right-sided hemilaminectomy at L2. Histologic examination of biopsy samples obtained from the mass revealed an ill-defined zone of mature vascular proliferation extending through the preexisting vertebral bone, consistent with vertebral angiomatosis. After surgical recovery, adjuvant radiation therapy was initiated with a total dose of 48 Gy administered in 16 fractions of 3 Gy each over a 3-week period. Neurologic function rapidly improved to full ambulation with only minimal monoparesis of the right pelvic limb. Results of neurologic and MRI examination performed 26 months after surgery indicated no change in neurologic status or evidence of recurrence.

CLINICAL RELEVANCE To the authors' knowledge, this report was the first to describe the long-term outcome for vertebral angiomatosis in a cat. Surgical decompression and radiation therapy provided an excellent outcome in this case. Vertebral angiomatosis should be considered as a differential diagnosis for any young cat with thoracolumbar myelopathy secondary to a mass associated with the vertebral pedicle.

Contributor Notes

Address correspondence to Dr. Hans (ehans.dvm@gmail.com).

Dr. Foss's present address is the Veterinary Teaching Hospital, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.