Clinical, Pathological and Immunohistochemical Evaluation of a Primary Hemangiosarcoma in a Pinscher Dog

Denner Santos dos Anjos, Andreia Regis Assis, Carlos Eduardo Fonseca-Alves, Veronica Jorge Babo-Terra

Abstract


Background: Hemangiosarcoma (HSA) is a malignant tumor that arises from the vascular endothelium affecting more often dogs than other species as cats, cows and horses. It comprises approximately 2% of all tumors in dogs. The most common primary site for the HSA in dogs is the spleen, and other locations include the right atrium, pericardium, liver and
prostate. Other authors have reported this tumor in lungs, kidney, oral cavity, muscle, bone, urinary bladder, left ventricle, tongue and retroperitoneum. Due to the importance of the HSA in canine species, the aim of this study was to describe the clinical and pathological fndings, besides therapeutic protocol in an unusual case of HSA.
Case:A six-year-old male pinscher was referred to the veterinary hospital with a history of cyanosis and choking. The animal was submitted to radiographic examination in lateral cervical view, which identifed the presence of a mass of 1.2 cm in diameter near the pharynx. In order to evaluate the oral cavity, general anesthesia was performed, and it was possible to see a soft, rosy, circumscribed and vascularized lump in pharyngeal region. Due to suspicion of neoplasm, excisional biopsy
without surgical margin was performed. The histopathological exam diagnosed hemangiosarcoma. Immunohistochemistry against vimentin, factor VIII, VEGF and Ki67 was performed and confrmed diagnosis of low grade hemangiosarcoma. Antineoplastic chemotherapy protocol was initiated with doxorubicin and cyclophosphamide every 21 days totaling six
sessions. However, the animal died after the cyclophosphamide intoxication with a three-fold recommended dose (660 mg/m² total in the last session), showing a median survival rate of 220 days.
Discussion: The most common primary site for HSA in dogs is the spleen. The pharyngeal location is rare, with only a few reports in literature. In the present case, solitary tumor was observed in pharynx with no involvement of other organs, evidenced by radiographic examination, abdominal ultrasound and echocardiogram, suggesting that pharynx was the
primary location of the tumor. Main features of HSA comprise a solitary nodule or multifocal lesions within the organ or widely disseminated. Histologically, they consist of pleomorphic immature endothelial cells with formation of vascular spaces with variable amount of blood and/or thrombi. In some cases, HSA shows a polymorphic subtype and immuno
histochemistry is necessary to provide a defnitive diagnosis. The sample was submitted to histopathological examination which revealed proliferation of endothelial cells with pronounced pleomorphism ranging from polygonals to ovoid, sparse cytoplasm, round to oval nucleus with visible nucleolus, few mitotic fgures, some of them, aberrant, which confrmed diagnosis of HAS. Due to the unusual location, we performed immunohistochemical staining for vimentin, factor VIII,
VEGF and Ki67 antibodies to confrm mesenchymal origin of the tumor. In IHC, it was possible to identify positive reac tion for vimentin protein, factor VIII, VEGF and few Ki67 positive cells, confrming histopathological diagnosis. Despite literature describes an aggressive biological behavior of canine HSA, with common occurrence of metastasis, recurrence
was not observed at the site of the removal of the tumor. In histopathological evaluation, it was observed low number of
mitoses, besides the low Ki67 expression on IHC, featuring a low grade tumor with minor ability to metastasize. To the author’s knowledge, this case describes an unusual presentation of HSA, with low metastatic potential, in which chemo therapy protocol achieved survival time of 220 days.
Keywords: angiosarcoma, dogs, immunohistochemistry, pharynx.

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References


Brown N.O., Patnaik A.K. & MacEwen E.G. 1985. Canine hemangiosarcoma:retrospective analysis of 104 cases. Journal of American Veterinary Medical Association. 186: 56-58.

Clifford C.A., Mackin A.J. & Henry C.J. 2000. Treatment of canine hemangiosarcoma: 2000 and beyond. Journal of Veterinary Internal Medicine. 14: 479-485.

Day M.J., Lucke V.M. & Pearson H. 1995. A review of pathological diagnoses made from 87 canine splenic biopsies, Journal of Small Animal Practice. 36(10): 426-433.

Dennis M.M., Ehrhart N., Duncan C.G., Barnes A.B. & Ehrhart E.J. 2006. Frequency of and risk factors associated with lingual lesions in dogs: 1,196 cases (1995-2004). Journal of American Veterinary Medical Association. 228: 1533-1537.

Fernandes S.C. & Nardi A.B. 2009. Hemangiossarcoma. In: Suely Rodaski (Ed). Oncologia em cães e gatos. Rio de Janeiro: Editora Roca Ltda., pp.526-537.

Flores M.M., Panziera W., Kommers G.D., Irigoyen L.F., Barros C.S.L. & Fighera R.A. 2012. Aspectos epidemiológicos e anatomopatológicos do hemangiossarcoma em cães: 40 casos (1965-2012). Pesquisa Veterinária Brasileira. 32(12): 1319-1328.

Gamlem H. & Nordstoga K. 2008. Canine vascular neoplasia- histologic classifcation and inmunohistochemical analysis of 221 tumours and tumour-like lesions. Acta Pathologica Microbiologica Scandinavica. Suppl.(125): 19-40.

Guinan J., Fischetti A., Garate A.P. & Chalhoub S. 2012. Primary periaortic hemangiosarcoma in a dog. Cancer Veterinary Journal. 53(11): 1214-1218.

Head K.W., Else R.W. & Dubielzing R.R. 2002. Tumors and tumor like lesions of vascular tissue. In: Donald Meuten (Ed). Tumors in Domestic Animals. 4th edn. Ames: Iowa State Press, pp.434-435.

Liptak J.M., Dernell W.S. & Withrow S.J. 2004. Haemangiosarcoma of the urinary bladder in a dog. Australian Veterinary Journal. 82(4): 215-217.

Liptak J.M., Dernell W.S., Ehrhart E.J., Rizzo S.A., Rooney M.B. & Withrow S.J. 2004. Retroperitoneal sarcomas in dogs: 14 cases (1992-2002). Journal of American Veterinary Medical Association. 224: 1471-1477.

Locke J.E. & Barber L.G. 2006. Comparative aspects and clinical outcomes of canine renal hemangiosarcoma. Journal of Veterinary Internal Medicine. 20: 962-967.

Marshall A., McGrath C., Torigian D., Papanicolaou N., Lal P. & Kaplan Tweed C. 2012. Low-dose cyclophosphamide associated with hemorrhagic cystitis in a breast cancer patient. Breast Journal. 18: 272-275.

Merlo E.M. & Muñoz L.A. 2011. Hemangiosarcoma canino. In: Elena Martinez Merlo (Ed). Manual práctico de oncología en pequeños animales. Madrid: Salud Animal, pp.161-180.

Miller M.A., Ramos J.A. & Kreeger J.M. 1992. Cutaneous vascular neoplasia in 15 cats: clinical, morphologic, and immunohistochemical studies. Veterinary Pathology. 29: 329-336.

Ogilvie G.K., Powers B.E., Mallinckrodt C.H. & Withrow S.J. 1996. Surgery and doxorubicin in dogs with hemangiosarcoma. Journal of Veterinary Internal Medicine. 10: 379-384.

Papadimitriou A.S., Anatolitou A., Brellou G., Kouki M.I. & Viemmas I. 2014. Gingival hemangiosarcoma of the left mandible in a dog. The Journal of Veterinary Medical Science. 2(1): 4.

Peterson J., Couto C., Hammer A. & Ayl A.D. 1992. Acute sterile hemorrhagic cystitis after single intravenous administration of cyclophosphamide in three dogs. Journal of American Veterinary Medical Association. 201: 1572-1573.

Schultheiss P.C. 2004. A retrospective study of visceral and nonvisceral hemangiosarcoma and hemangiomas in domestic animals. Journal of Veterinary Diagnostic Investigation. 16: 522-526.

Sorenmo K.U., Jeglum K.A. & Helfand S.C. 1993. Chemotherapy of canine hemangiosarcoma with doxorubicin and cyclophosphamide. Journal of Veterinary Internal Medicine. 7: 370-376.

Spangler W.L. & Kass P.H. 1997. Pathologic factors affecting postsplenectomy survival in dogs. Journal of Veterinary Internal Medicine. 11: 166-171.

Stanton M. & Legendre A. 1986. Effects of cyclophosphamide in dogs and cats. Journal of American Veterinary Medical Association. 188: 1319-1322.

Stock M.L., Smith B.I. & Engiles J.B. 2011. Disseminated hemangiosarcoma in a cow. Cancer Veterinary Journal. 52: 409-413.

Thamm D.H. 2013. Miscellaneous tumors. In: Withrow & MacEwen’s (Ed). Small Animal clinical oncology. 5th edn. St. Louis: Elsevier, pp.679-687.

Von Beust B.R., Suter M.M. & Summers B.A. 1988. Factor VIII-related antigen in canine endothelial neoplasms: An immunohistochemical study. Veterinary Pathology. 25: 251-255.

Ward H., Fox L.E., Calderwood-Mays M.B., Hammer A.S. & Couto C.G. 1994. Cutaneous hemangiosarcoma in 25 dogs: a retrospective study. Journal of Veterinary Internal Medicine. 8: 345-348.




DOI: https://doi.org/10.22456/1679-9216.84538

Copyright (c) 2018 Denner Santos dos Anjos, Andreia Regis Assis, Carlos Eduardo Fonseca-Alves, Veronica Jorge Babo-Terra

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