Cerebral Cavernous Hemangioma in a Dog

Viviane Motta dos Santos Moretto, Luciana Maria Curtio Soares, Esthefanie Nunes, Uiara Hanna Araújo Barreto, Valéria Régia Franco Sousa, Pedro Eduardo Brandini Nespoli, Edson Moleta Colodel, Arlena do Bom Parto Ferreira de Almeida


Background: Cerebral cavernous hemangioma is a rare neoplasm of vascular origin in the brain, characterized by abnormally dilated vascular channels surrounded by endothelium without muscle or elastic fibers. Presumptive diagnosis is performed by magnetic resonance or computed tomography (CT) scanning and can be confirmed by histopathology. The prognosis of intracranial cavernous hemangioma is poor, with progression of clinical signs culminating in spontaneous death or euthanasia. The purpose of this paper is to report a case of cerebral cavernous hemangioma in a dog, presenting the clinical findings, tomographic changes, and pathological findings.

Case: This case involved a 2-year-old medium sized mixed breed female dog presenting with apathy, hyporexia, ataxia, bradycardia, dyspnea, and seizure episodes for three days. Hemogram and serum biochemistry of renal and hepatic function and urinalysis did not reveal any visible changes. CT scanning was also performed. The scans revealed a hyperdense nodule of 15.9 x 14 mm, with well defined borders, and a hypodense halo without post-contrast enhancement and mass effect in the right parietal lobe was observed in both transverse and coronal sections. Based on the image presented in the CT scans, the nodule was defined as a hemorrhagic brain lesion. The animal died after a seizure. The right telencephalon was subjected to necropsy, which revealed a reddish-black wel-defined nodule 1.7 cm in diameter extending from the height of the piriform lobe to the olfactory trine at the groove level and extending towards the lateral ventricle, with slight compression and deformation of the thalamus but no other macroscopic alterations in the other organs. The histopathology indicated that this nodular area in the encephalus contained moderate, well-delimited but unencapsulated cellularity, composed of large vascular spaces paved with endothelial cells filled with erythrocytes, some containing eosinophilic fibrillar material (fibrin) and others with organized thrombus containing occasional neutrophil aggregates. The endothelial cells had cytoplasm with indistinct borders, elongated nuclei, scanty crust-like chromatin, and cellular pleomorphism ranging from discrete to moderate, without mitotic figures.

Discussion: The histological findings characterized the morphological changes in the brain as cavernous hemangioma, and the growth and compression of this neoplasm were considered the cause of the clinical signs of this dog. The main complaint was seizures, although ataxia and lethargy were also noted. These clinical signs are often related to changes in the anterior brain and brainstem. The literature does not list computed tomography as a complementary diagnostic method in cases of cerebral cavernous hemangioma in dogs, but CT scanning was useful in confirming cerebral hemorrhage. The main differential diagnosis for cerebral cavernous hemangioma would be a hamartoma, but what differentiates them histologically is the presence of normal interstices between the blood vessels, since no intervening neural tissue occurs in the case of cerebral hemangioma. Therefore, even in the absence of immunohistochemistry to more confidently confirm a cavernous hemangioma, the clinical signs, CT scans and especially the pathological findings were consistent with a case of cerebral cavernous hemangioma, a benign neoplasm with a poor prognosis due to the severe neurological changes it causes and its difficult treatment.

Full Text:



Bentley R.T. 2015. Magnetic resonance imaging diagnosis of brain tumors in dogs. The Veterinary Journal. 205(2): 204-216.

Boudreau C.E. 2018. An Update on Cerebrovascular Disease in Dogs and Cats. Veterinary Clinic Small Animals. 48(1): 45-62.

Eichelberg B.M., Kraft S.L., Halsey R.D.P., Miller M.D. & Klopp L. 2011. Imaging Diagnosis - magnetic resonance imaging findings of primary cerebral hemangioma. Veterinary Radiology & Ultrasound. 2(52): 188-191.

Gabor L.J. & Vanderstichel R.V. 2006. Primary Cerebral Hemangiosarcoma in a 6-Week-Old Dog. Veterinary Pathology. 43(5): 782-784.

Hodgin E.C. 1985. Meningeal Hemangioma and Renal Hamartoma in a Heifer. Veterinary Pathology. 1(22): 420-42.

Jones J.C. 2002. Clinical Neurology in Small Animals - Localization, Diagnosis and Treatment. International Veterinary Information Service. [Fonte: ]. [Accessed online in March 2019].

McGavin M.D. & Zachary J.F. 2013. Bases da Patologia em Veterinária. 5.ed. Rio de Janeiro: Elsevier, 1324p.

Meuten D.J. 2017. Tumors in Domestic Animals. 5nd edn. Ames: John Wiley & Sons, 989p.

Miller A.G., Halsey C.H., Miller M.D. & Bohn A.A. 2011. What is your diagnosis? Intracranial mass in a dog. Veterinary Clinical Pathology. 40(4): 563-564.

Roelcke U., Boxheimer L., Fathi A.R., Schwyzer L., Ortega M., Berberat J. & Remonda L. 2013. Cortical hemosiderin is associated with seizures in patients with newly diagnosed malignant brain tumors. Journal of Neuro-Oncology. 115(3): 463-468.

Ruan D., Yu X., Shrestha S., Wang L. & Chen G. 2015. The Role of Hemosiderin Excision in Seizure Outcome in Cerebral Cavernous Malformation Surgery: A Systematic Review and Meta-Analysis. Plos one. 10(8): 1-14.

Sakurai M., Morita T., Kondo H., Uemura T., Haruna A. & Shimada A. 2011. Cerebral Vascular Hamartoma with Thrombosis in a Dog. Journal of Veterinary Medical Science. 73(10): 1367-1369.

Schwarz T. & Saunders J. 2011. Veterinary Computed Tomography. Chichester: Wiley-Blackwell Ltd., 576p.

Shihab N., Summers B.A., Benigni L., McEvoy A.W. & Volk H.A. 2014. Novel Approach to Temporal Lobectomy for Removal of a Cavernous Hemangioma in a Dog. Veterinary Surgery. 43(7): 877-881.

Schultheiss P.C. 2004. A retrospective study of visceral and nonvisceral hemangiosarcoma and hemangiomas in domestic animals. Journal of Veterinary Diagnostic Investigation. 16(6): 522-526.

Smith S.H. & Van Winkle T. 2001. Cerebral Vascular Hamartomas in Five Dogs. Veterinary Pathology. 38(1): 108-112.

Stalin C.E., Granger N. & Jeffery N.D. 2008. Cerebellar vascular hamartoma in a British Shorthair cat. Journal of Feline Medicine and Surgery. 10(2): 206-211.

Thomas W.B., Adams W.H., McGavin M.D. & Gompf R.E. 1997. Magnetic resonance imaging appearance of intracranial hemorrhage secondary to cerebral vascular malformation in a dog. Veterinary Radiology & Ultrasound. 38(5): 371-375.

van der Gaag I., Vos J.H., van der Linde-Sipman J.S. & Koeman J.P. 1989. Canine Capillary and Combined Capillary-cavernous Haemangioma. Journal of Comparative Pathology. 101(1): 69-74.

Vandevelde M., Higgins R.J. & Oevermann A. 2012. Veterinary Neuropathology: Essentials of Theory and Practice. Oxford: John Wiley & Sons, 216p.

Wang X., Tao Z., You C., Li Q. & Liu Y. 2013. Extended resection of hemosiderin fringe is better for seizure outcome: A study in patients with cavernous malformation associated with refractory epilepsy. Neurology India. 61(3): 288-292.

DOI: https://doi.org/10.22456/1679-9216.97398

Copyright (c) 2019 Viviane Motta dos Santos Moretto, Luciana Maria Curtio Soares, Esthefanie Nunes, Uiara Hanna Araújo Barreto, Valéria Régia Franco Sousa, Pedro Eduardo Brandini Nespoli, Edson Moleta Colodel, Arlena do Bom Parto Ferreira de Almeida

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.