Case Description—A 2-year-old Siberian Husky was evaluated because of a 2-week history of coughing and gagging and decreased appetite and activity level.
Clinical Findings—Radiography, surgery, and immunohistochemical examination revealed a solitary sclerosing mesothelioma extending from the left thoracic diaphragmatic surface that was adherent to the pericardium and the caudal mediastinum.
Treatment and Outcome—The tumor was resected along with most of the left hemidiaphragm, and the left transversus abdominis muscle was used to reconstruct the diaphragm. The 13th rib formed the base of the muscle flap. The muscle flap was transposed into the defect so that the mesothelium-lined surface faced the thoracic cavity and the deep aspect of the muscle formed the abdominal surface of the diaphragm. To minimize risk of adhesions, the exposed raw aspect of the abdominal surface was covered with porcine small intestinal submucosa. Recovery was uncomplicated, and the dog's appetite and activity level soon returned to normal. Evaluation 54 days after surgery revealed 2 subcutaneous masses on the thorax and masses in the liver and both kidneys; histologic and immunohistochemical analyses revealed metastasis of the original tumor. The dog was euthanatized.
Clinical Relevance—Hemidiaphragmatic reconstruction with a transversus abdominis muscle flap after resection of a diaphragmatic tumor was successful. The muscle flap was easily harvested and transposed into the diaphragmatic defect.
CASE DESCRIPTION A 12-year-old neutered male domestic shorthair cat had been treated for a mass arising from the lingual aspect of the caudal right mandibular body. Cytoreductive surgery of the mass had been performed twice over a 2-year period, but the mass recurred following both surgeries. The mass was diagnosed as an osteosarcoma, and the cat was referred for further evaluation and treatment.
CLINICAL FINDINGS Clinical findings were unremarkable, except for a 2-cm-diameter mass arising from the lingual aspect of the right mandible and mild anemia and lymphopenia. Pre- and postcontrast CT scans of the head, neck, and thorax were performed, revealing that the osteosarcoma was confined to the caudal right mandibular body, with no evidence of lymph node or pulmonary metastasis.
TREATMENT AND OUTCOME The stereolithographic files of the CT scan of the head were sent for computer-aided design and manufacture of a customized 3-D–printed titanium prosthesis. Segmental mandibulectomy was performed, and the mandibular defect was reconstructed in a single stage with the 3-D–printed titanium prosthesis. The cat had 1 minor postoperative complication but had no signs of eating difficulties at any point after surgery. The cat was alive and disease free 14 months postoperatively.
CLINICAL RELEVANCE Reconstruction of the mandible of a cat following mandibulectomy was possible with computer-aided design and manufacture of a customized 3-D–printed titanium prosthesis. Cats have a high rate of complications following mandibulectomy, and these initial findings suggested that mandibular reconstruction may reduce the risk of these complications and result in a better functional outcome.
CASE DESCRIPTION A 13-year-old Labrador Retriever with a 4-cm-diameter ulcerated perianal mass and a 12-year-old Golden Retriever with a 5-cm-diameter ulcerated caudolateral abdominal mass were brought to a referral oncology practice for evaluation of the dermal masses. Both masses were resected with wide margins without reported postoperative complications. For both dogs, a diagnosis of collision tumor was made. The database of the Veterinary Diagnostic Laboratories at Colorado State University was searched for other examples of collision tumors in dogs.
CLINICAL FINDINGS Histologic assessment of the masses revealed collision tumors in both patients. The perianal mass was diagnosed as a perianal gland carcinoma with adjacent hemangiosarcoma. The flank mass was diagnosed as a fibrosarcoma with an adjacent mast cell tumor. The university database search of sample submissions in 2008 through 2014 for the keywords collision, admixed, or adjacent yielded 37 additional cases of dogs with malignant nontesticular collision tumors.
TREATMENT AND OUTCOME Both dogs were treated with surgery alone and received no adjunctive treatments. Both tumors were completely excised. There was no evidence of either local tumor recurrence or metastasis in the Labrador Retriever and the Golden Retriever at 1,009 and 433 days after surgery, respectively.
CLINICAL RELEVANCE Collision tumors are rare, and there is minimal information regarding treatment recommendations and outcome for animals with collision tumors. On the basis of the 2 cases described in this report, the outcome associated with treatment of collision tumors may be similar to the expected outcome for treatment of any of the individual tumor types in dogs.
Objective—To determine outcomes and prognostic factors for those outcomes in dogs with appendicular osteosarcoma treated with curative-intent surgery and adjuvant carboplatin.
Design—Retrospective case series.
Animals—65 client-owned dogs with appendicular osteosarcoma and no evidence of gross metastatic disease at the time of diagnosis.
Procedures—Medical records of dogs that underwent limb amputation or distal ulnectomy and adjuvant carboplatin treatment for appendicular osteosarcoma were reviewed. Adverse effects of chemotherapy and findings regarding preoperative biopsy specimens and postoperative diagnostic imaging were recorded. Signalment, clinical history, and chemotherapy variables were evaluated for associations with outcome. Histologic grade and other variables were evaluated for association with outcome for 38 tumors that were retrospectively graded.
Results—The median disease-free interval was 137 days (95% confidence interval [CI], 112 to 177 days). Median survival time was 277 days (95% CI, 203 to 355 days). The 1-, 2-, and 3-year survival rates were 36%, 22%, and 19%, respectively. None of the chemotherapy variables were associated with outcome. Preoperative proteinuria was the only clinical variable associated with poor outcome. Histologic features of tumors associated with a poor outcome were intravascular invasion, mitotic index > 5 in 3 microscopic hpfs, and grade III classification.
Conclusions and Clinical Relevance—Carboplatin administration was well tolerated and resulted in a disease-free interval and median survival time similar to those of other published protocols.
Objective—To determine the efficacy and toxic effects of epirubicin for the adjuvant treatment of dogs with splenic hemangiosarcoma and identify prognostic factors.
Design—Retrospective case series.
Animals—59 client-owned dogs that underwent splenectomy for splenic hemangiosarcoma treated with or without epirubicin.
Procedures—Medical records were examined for signalment, clinical signs, diagnostic and surgical findings, and postoperative outcome. For dogs treated with epirubicin, dose numbers, intervals, and reductions and type and severity of toxic effects were recorded. Dogs were allotted to 2 groups: splenectomy alone and splenectomy with adjuvant epirubicin treatment.
Results—18 dogs received epirubicin (30 mg/m2) every 3 weeks for up to 4 to 6 treatments. Forty-one dogs were treated with splenectomy alone. The overall median survival time was significantly longer in dogs treated with splenectomy and epirubicin (144 days), compared with splenectomy alone (86 days). Median survival time for dogs with stage I disease (345 days) was significantly longer than for dogs with either stage II (93 days) or III disease (68 days). Seven of 18 dogs treated with epirubicin were hospitalized for signs of adverse gastrointestinal effects. Inappetence, long duration of clinical signs, thrombocytopenia, neutrophilia, and high mitotic rate were negative prognostic factors.
Conclusions and Clinical Relevance—Epirubicin may be as efficacious as adjuvant doxorubicin-based protocols, but may result in a higher incidence of adverse gastrointestinal effects. Epirubicin should be considered as an alternative to doxorubicin in dogs with preexisting cardiac disease, as clinical epirubicin cardiotoxicity was not diagnosed in treated dogs.
To compare use of a vessel-sealing device (VSD) versus conventional hemostatic techniques in dogs undergoing thyroidectomy because of suspected thyroid carcinoma.
Retrospective cohort study.
42 client-owned dogs undergoing thyroidectomy because of suspected thyroid carcinoma.
Medical records of dogs treated at 4 referral centers from 2010 through 2016 were reviewed, and information was obtained on patient signalment, surgical technique, tumor-specific factors, and operative duration. Postoperative hospitalization time and complications were compared between dogs grouped on the basis of hemostatic technique.
Thyroidectomy was performed with a VSD in 23 dogs and with conventional hemostatic techniques (ie, ligatures, hemoclips, or electrocautery) in 19 dogs. Hemostatic technique (ie, use of a VSD vs conventional hemostatic techniques) was the only factor significantly associated with operative duration (median time, 28 vs 41 minutes). Postoperative hospitalization times and complication rates did not differ between groups.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that use of a VSD, rather than conventional hemostatic techniques, in dogs undergoing thyroidectomy because of suspected thyroid carcinoma resulted in shorter operative times without significantly affecting complication rates or postoperative hospitalization times.
Objective—To describe the clinical signs, diagnostic findings, surgical management, and outcome in dogs with splenic liposarcoma.
Design—Retrospective case series.
Animals—13 client-owned dogs with splenic liposarcoma.
Procedures—Medical and pathology records of dogs with a histopathologic diagnosis of splenic liposarcoma from 2002 to 2012 were reviewed for the following data: clinical signs, CBC, biochemical profile, thoracic and abdominal imaging, surgical management, histologic grade, and outcome (local recurrence, distant metastasis, and survival time). Telephone interviews were conducted with referring veterinarians.
Results—The median survival time (MST) was 623 days (range, 1 to 1,283 days). In 5 dogs that died of splenic liposarcoma, survival times ranged from 42 to 369 days. Metastasis at the time of surgery was a negative prognostic indicator: the MST was 45 days for dogs with metastasis and 767 days for dogs without metastasis. Dogs with grade 1 splenic liposarcoma had a significantly greater MST (1,009 days), compared with dogs with grade 2 or 3 splenic liposarcoma (MST, 206 and 74 days, respectively).
Conclusions and Clinical Relevance—Results confirmed that splenic liposarcoma is a rare differential diagnosis in dogs with a splenic mass. Survival time was influenced by preoperative clinical stage and histologic grade.
Objective—To determine prognostic factors for and compare outcome among dogs with oral malignant melanoma following excision with or without various systemic adjuvant therapies.
Design—Retrospective case series.
Animals—151 dogs with naturally occurring oral malignant melanomas treated by excision with or without adjuvant therapies from 2001 to 2012.
Procedures—Case accrual was solicited from Veterinary Society of Surgical Oncology members via an email list service. Information collected from case records included signalment, tumor staging, tumor characteristics, type of surgical excision, histologic diagnosis, adjuvant therapy, and survival time.
Results—The overall median survival time was 346 days. Results of multivariate analysis indicated that tumor size, patient age, and intralesional excision (vs marginal, wide, or radical excision) were considered poor prognostic indicators. All other demographic and clinical variables were not significantly associated with survival time after adjusting for the aforementioned 3 variables. A clear survival benefit was not evident with any systemic adjuvant therapy, including vaccination against melanoma or chemotherapy; however, the number of dogs in each treatment group was small. Ninety-eight dogs received no postoperative adjuvant therapy, and there was no difference in survival time between dogs that did (335 days) and did not (352 days) receive systemic adjuvant therapy.
Conclusions and Clinical Relevance—For dogs with oral malignant melanoma, increasing tumor size and age were negative prognostic factors. Complete excision of all macroscopic tumor burden improved survival time. Long-term survival was possible following surgery alone. Although systemic adjuvant therapy was not found to improve survival time, this could have been due to type II error.
Objective—To determine clinical signs, diagnostic
findings, outcome, and prognostic factors in dogs
treated surgically for massive hepatocellular carcinoma
(HCC) and compare survival times of surgically
and conservatively treated dogs.
Procedure—Medical records were examined for clinical
signs, diagnostic and surgical findings, and postoperative
outcome. Dogs were allocated into surgery
and nonsurgery groups depending on whether curative-
intent liver lobectomy was performed. Data from
the surgical and nonsurgical groups were analyzed to
identify prognostic factors and determine and compare
rates of tumor control and survival time.
Results—42 dogs were treated surgically, and 6 were
managed conservatively. In the surgery group, intraoperative
mortality rate was 4.8% with no local recurrence,
metastatic rate was 4.8%, and median survival
time was > 1,460 days (range, 1 to 1,460 days). High
alanine aminotransferase and aspartate aminotransferase
activities were associated with poor prognosis.
Median survival time for the nonsurgery group was
270 days (range, 0 to 415 days), which was significantly
less than that of surgically treated dogs.
Conclusions and Clinical Relevance—Liver lobectomy
is recommended for dogs with massive HCC
because tumor-related mortality rate was 15.4 times
higher in dogs in the nonsurgery group, compared
with the surgery group. Tumor control was excellent
after surgical resection with no local recurrence and a
low metastatic rate. Prognostic factors were identified,
but their clinical relevance was uncertain
because only 9.5% of dogs in the surgery group died
as a result of their disease. (J Am Vet Med Assoc
Objective–To describe the clinical features, surgical
and histologic findings, biological behavior, and outcome
of dogs with retroperitoneal sarcomas.
Procedures–Medical and pathology records from 1992
to 2002 of dogs with tumors originating in the retroperitoneal
space were reviewed. Dogs with retroperitoneal
tumors originating from the adrenal glands, kidneys, or
ureters were excluded. Inclusion criteria included observation
of a tumor arising from the retroperitoneal space
during exploratory surgery or necropsy and histologic
confirmation of tumor type. Details of clinical signs, diagnostic
findings, surgical management, and outcome
were determined from medical records and telephone
interviews with veterinarians and owners.
Results–Retroperitoneal sarcoma was diagnosed in
14 dogs, 2 at necropsy and 12 during exploratory
surgery. Hemangiosarcoma was the most common
histologic diagnosis. Seven dogs had regional extension
of the sarcoma into adjacent organs, and 4 dogs
had metastatic disease. Grossly complete resection
was possible in 6 dogs. Cytoreductive surgery or incisional
biopsy was performed in the remaining dogs.
Two dogs were treated with palliative radiation therapy
(1 intraoperatively and 1 postoperatively). Three
dogs received adjunctive chemotherapy, although
none completed the targeted course because of
development of local recurrence or metastatic disease.
Local recurrence was reported in 2 of 12 dogs
and metastasis in 10 of 14 dogs. Thirteen dogs died or
were euthanatized as a result of the retroperitoneal
sarcoma; 1 dog was alive and disease-free 410 days
after surgery. Median survival time was 37.5 days.
Conclusions and Clinical Relevance–In dogs,
retroperitoneal sarcomas are aggressive tumors with
a high rate of local recurrence and metastasis, and a
poor survival time. (J Am Vet Med Assoc 2004;224: