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Right lateral view (A), longitudinal sections (B and C) and ventral view (D) of the heart, showing mass lesions of hemangiosarcoma arising from the right auricle (A), right atrium (B), right ventricle (C) and left atrium. Scale, 1 mm.
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In the study presented here, we aimed to describe the epidemiological, clinical and pathological findings of 51 canine cases with histologically-verified diagnoses of primary cardiac hemangiosarcoma (HSA). The medical data for each dog, including signalment, presenting complaints, physical examination findings, results of various diagnostic testing...
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To report the outcome of doxorubicin-based chemotherapy as the sole treatment for dogs with echocardiographically identified right atrial masses and pericardial effusion.
A retrospective study of case records of dogs with right atrial masses treated with doxorubicin. Dogs were excluded from the study if they had any type of surgery performed such a...
Citations
... Among them, tumour-related prognostic factors, especially the primary tumour location, surgical resection margin and biological behaviour of the tumour (Burton et al., 2012;Carloni et al., 2019;Cospodarowicz & O'sullivan, 2003;Mullin & Clifford, 2019), are closely associated with the median survival time (MST). Postsurgical MST was reported 48-86 days for spleen HSA (Brown et al., 1985;Batschinski et al., 2018;Goritz et al., 2013;Wendelburg et al., 2015;Wood et al., 1998) and 12-17 days for right atrium HSA (Mullin et al., 2014;Yamamoto et al., 2013), 278 days for kidney HSA (Locke & Barber, 2006) and 37.5-408 days for retroperitoneal HSA (Hillers et al., 2007;Liptak et al., 2004). Retroperitoneal HSA shows variable MSTs across reports; however, information of prognostic value of tumour-related factors is inconsistent. ...
... Prognostic factors were (Alvarez et al., 2013;Brown et al., 1985;Batschinski et al., 2018;Dahl et al., 2008;Story et al., 2020). In 1980, the World Health Organization classified into three clinical stages: stage I, tumour size <5 cm; stage II, rupture and involvement of the regional lymph nodes; stage III, distant metastasis (Mullin & Clifford, 2019;Singer et al., 1995;Yamamoto et al., 2013). Although no clinical stage completely affected MST or prognosis of HSA (Wendelburg et al., 2015), the advanced stage/stage III was a stronger poor prognostic factor compared to stage I or II (Brown et al., 1985;Batschinski et al., 2018;Cospodarowicz & O'sullivan, 2003;Story et al., 2020;Tomasetti & Vogelstein, 2015;Treggiari et al., 2020). ...
... In the previous study on retroperitoneal HSA (Yamamoto et al., 2013), (Griffin et al., 2021;Mallinckrodt & Gottfried, 2011;Treggiari et al., 2020). In addition, both spleen and liver HSA showed significant related to the shorter MST. ...
Background
Dogs with retroperitoneal hemangiosarcoma (HSA) exhibit variable postoperative median survival times (MST).
Objective
To retrospectively evaluate the prognostic value of selected tumour‐related factors, such as tumour size, rupture, invasion into adjacent tissue, involvement of lymph node and distant metastasis, they were analysed in dogs with retroperitoneal HSA.
Methods
Ten dogs with retroperitoneal HSA managed solely with surgical excision were reviewed and compared with spleen (71) and liver (9) HSA. The Kaplan–Meier method and log‐rank analysis were used compare MSTs between factors. Multivariable Cox proportional‐hazard analysis was used to compare differences between arising sites.
Results
Retroperitoneal HSA showed comparatively longer postoperative MST compared with that of spleen and liver HSA and demonstrated significantly longer MST (p = 0.003) for tumours ≥5 cm (195 days) than <5 cm (70 days). Spleen HSA revealed significantly shorter MSTs in involvement of distant lymph nodes (23 days) and distant metastasis (39 days) than those in negative (83 days, p = 0.002 and 110 days, p < 0.001, respectively). Liver HSA also revealed significantly shorter MST (16.5 days compared with 98 days, p = 0.003) for distant metastasis. Additionally, hazard ratios (HRs) and their forest plot for overall HSA revealed as poor prognostic factors, arising sites (spleen; HR 2.78, p = 0.016 and liver; HR 3.62, p = 0.019), involvement of distant lymph nodes (HR 2.43, p = 0.014), and distant metastasis (HR 2.86, p < 0.001), and as better prognostic factor of tumour size ≥5 cm (HR 0.53, p = 0.037).
Conclusion
In combination with overall HSA, retroperitoneal HSA shows comparatively longer postoperative MST compared to spleen and liver HSA, associated with tumour size ≥5 cm suggesting better prognostic factor.
... The signs of hemoabdomen warrant prompt attention and tumor assessment for diagnosis, possibly explaining the higher prevalence of diagnosed splenic HSA. It was interesting that cardiac HSA was not observed in this study, despite being commonly reported as a primary site for HSA in dogs [25,26]. Antemortem diagnosis of a cardiac tumor using cytology or biopsy is challenging, and necropsy typically serves as the final diagnostic tool in identifying the type of cardiac HSA. ...
Vascular neoplasms, including hemangiosarcoma (HSA) and hemangioma (HMA), are more common in dogs than other domestic animal species; however, comprehensive laboratory screening tests for early diagnosis are currently limited. The aims of this study were to investigate general signalments, anatomic locations, and clinicopathological abnormalities of dogs diagnosed with vascular neoplasms and to determine the diagnostic significance of these abnormalities. Retrospective data of dogs with HMA, HSA, and healthy dogs were analyzed. Dogs with HMA and HSA were seniors, with mixed breeds being most affected. HMA affected predominantly non-visceral sites, while HSA was more common in visceral sites, particularly the spleen. In multivariate model analyses, the odds of HMA diagnosis were 5.5 times higher in anemic dogs and 33.0 times higher in lymphopenic dogs compared to dogs without the abnormalities. The odds of HSA diagnosis were 42.5 times higher in anemic dogs, 343 times higher in lymphopenic dogs and 92.7 times higher in dogs with hyperfibrinogenemia compared to dogs without the abnormalities. The study suggested that these identified abnormalities were nonspecific and commonly observed in various chronic diseases, and hence their combination with clinical information, such as diagnostic imaging and histopathology, is important to facilitate a more precise diagnosis of canine vascular neoplasms.
... Predilekčním místem pro výskyt metastatických ložisek jsou plíce, játra, slezina nebo omentum. 4,5 Tumory srdce se vyskytují převážně u starších psů, s největším postižením mezi 7-15 rokem života. Některé z nich způsobují závažné klinické příznaky, ale jiné mohou být asymptomatické a jsou tedy diagnostikovány pouze náhodně. ...
In this article, we describe in detail the case of a 9-year-old female border collie who underwent a resection of the right atrial appendage combined with subtotal pericardectomy for recurrent pericardial effusion caused by a neoplastic process. The occurrence of heart tumors and their surgical solutions are not a common aspect of routine veterinary practice. Therefore, in the case report, our primary emphasis is on the surgical procedure itself.
... Cardiac tumors are rare in dogs, with an overall incidence rate of only 0.19% (18,21). Among the various types of cardiac tumors, hemangiosarcoma (HSA) is the most common, accounting for 69% of all identified cases according to histologic type (17,18). ...
... Canine cardiac HSA is a highly malignant tumor that arises from pluripotent bone marrow progenitor cells (7,19). Although there was once a hypothesis that it originates from the vascular endothelium, recent evidence supports its bone marrow origin (4,21). The tumor is highly metastatic and can spread to distant organs through hematogenous routes, with the lungs being the most commonly affected site (4). ...
... Canine cardiac HSA (cHSA) can result in various mild to severe clinical symptoms (17), with pericardial effusion being the most common (17,21). cHSA can also cause right-sided congestive heart failure, decreased preload, and even tamponade. ...
... Гемангіосаркоми поділяються на два типи відповідно до їх розташування або походження: невісцеральні гемангіосаркоми та вісцеральні гемангіосаркоми (Yamamoto et al., 2013). Невісцеральні гемангіосаркоми можуть вражати шкіру, підшкірні тканини та м'язові тканини. ...
... Оскільки гемангіосаркома виникає з кровоносних судин, коли вона досягає неприйнятного розміру, вона розривається, що часто призводить до небезпечної для життя внутрішньої кровотечі (Yamamoto et al., 2013). Інші типові симптоми пов'язані з розміром пухлини, яка перешкоджає роботі серця це -перекачування крові в серцевий орган або з нього може бути заблоковано або сповільнено, що призводить до нерегулярного серцевого ритму; перикардіальна сумка, яка оточує серце, може наповнитись кров'ю через розірвані судини або рідиною, яка чинить обмежувальний тиск на серце; або може виникнути здуття живота, яке чинить тиск на серце та інші органи. ...
... Це найпоширеніший тип злоякісної пухлини серця, що становить приблизно 70 % новоутворень серця у собак (Carnio et al., 2020). Хоча пухлини серця можна побачити в будь-якій ділянці серця (тобто у вільній стінці лівого шлуночка, у міжшлуночковій перегородці) (Yamamoto et al., 2013), більшість первинних гемангіосарком серця вражають праве передсердя або шлуночок (Baioni et al., 2017). Через свою високоінвазивну природу прогноз гемангіосаркоми серця є несприятливим, середній час виживання становить 7 днів у собак без лікування (Treggiari et al., 2017), від 42 днів до 5 місяців у собак із хірургічним видаленням лише пухлини (Dickison et al., 2011), 139 днів у собак лише з хіміотерапією (Grieco et al., 2008) та від 175 до 189 днів у собак із хірургічним видаленням пухлини та традиційною хіміотерапією (Yamamoto et al., 2013). ...
Hemangiosarcoma is a prevalent and lethal type of cancer in dogs. The tumour grows and spreads rapidly , often giving no warning signs to the owner until the sudden death of the dog. Hemangiosarcoma typically affects older dogs. A confirmed case study of an animal's death shows that angiosarcoma mainly develops in dogs of a specific age and breed. The dog examined in this study was seven years old. Detecting cardiac hemangiosarcoma can be challenging, as X-ray exams may produce false-negative results, as seen in the current study. Pathological mitotic divisions are often the most recognizable sign of a heart tumour, which can be identified through an incisional biopsy. However, in our case, this was not feasible due to the patient's rapid decline. The patient's enlarged heart was visible on a chest X-ray, while an ultrasound revealed a pericardial effusion. Pericardiocentesis was performed, and 80 ml of hemorrhagic pericardial fluid was drained. Unfortunately, the results of the cytological examination of the fluid were negative, as confirmed by this study. Classic clinical signs of hemangiosarcoma are not present, except for abrupt and severe internal bleeding. The animal's owner reported periodic lethargy or fatigue and shortness of breath as clinical signs. During our examination, we noted tachycardia and muted heart sounds as additional clinical indications. During the pathological examination, the changes found in the body are not specific and may differ in individual cases of death. An autopsy established the absence of visual metastatic foci and in other organs: blood filling of the spleen; blood filling and liver enlargement; speckled haemorrhages on the lung pleura, mucous membrane of the stomach and small intestine; the mucous membrane of the large intestine is covered with a large amount of mucus and multiple haemorrhages. Histopathological studies have established a cavernous hemangioma, a large cavity of various shapes, filled with blood and lined with endothelium, separated by thin connective tissue partitions. In places, the blood in the cavities coagulates, and the formed thrombotic masses yield to their organizing.
... According to Boo et al. (14), the enucleation option is a curative treatment, without evidence of local recurrences and metastases. According to Yamamoto et al. (27), complete surgical removal of the tumor may offer better quality of life and therapeutic efficacy. ...
Hemangiosarcomas are tumors of mesenchymal origin, potentially deleterious, associated with areas of high vascularization. Tumor progression and growth are associated with these tumors’ ability to retain blood and give rise to tortuous blood vessels. They have a vast metastatic capacity, often occurring in organs such as the spleen, liver, and aorta artery. However, other sites may be affected, although less frequently, such as the third eyelid and the conjunctiva and cutaneous regions. This article aims to report the case of an 8-year-old female dog with a history of conjunctival hemangiosarcoma, in the medial region of the left eye, with a hemorrhagic appearance. The animal was submitted to the surgical procedure of enucleation after the involvement of the surgical margins in a previous histopathological examination.
... Surgery and adjuvant chemotherapy have resulted in median survival times of 141-179 days, with less than 10% of dogs surviving beyond one year (28-30). Cardiac HSA treated with surgical excision and adjuvant doxorubicin-based chemotherapy showed a similar response to splenic HSA, with median survival times of 183-189 days (97,98). For cutaneous HSA, surgery with or without adjuvant chemotherapy is generally performed (13). ...
Since the domestication of dogs 10,000 years ago, they have shared their living environment with humans and have co-evolved. The breeding process that dogs have undergone in only a few centuries has led to a significant accumulation of specific genetic alterations that could induce particular diseases in certain breeds. These canine diseases are similar to what is found in humans with several differences; therefore, comparing such diseases occurring in humans and dogs can help discover novel disease mechanisms, pathways, and causal genetic factors. Human angiosarcoma (AS) and canine hemangiosarcoma (HSA), which are sarcomas originating from endothelium, are examples of diseases shared between humans and dogs. They exhibit similar characteristics and clinical behaviors, although with some critical differences resulting from evolution. In this review, we will describe the similarities and differences in terms of clinical and molecular characteristics between human AS and canine HSA, and discuss how these similarities and differences can be applied to advance the treatment of these diseases.
... Hemangiosarcoma (HSA) in dogs is a malignant tumor derived from vascular endothelial cells or vascular endothelial progenitor cells of the bone marrow [9]. Hemangiosarcoma is more common in dogs than other species and can occur primarily in the spleen [15,16], skin, subcutis [4], right auricle, and right atrium [18]. Rupture of splenic or hepatic HSA can result in fatal hypovolemic shock due to intraperitoneal hemorrhage [2], while HSA in the right auricle or right atrium can cause cardiac tamponade, leading to fatal restrictive shock [18]. ...
... Hemangiosarcoma is more common in dogs than other species and can occur primarily in the spleen [15,16], skin, subcutis [4], right auricle, and right atrium [18]. Rupture of splenic or hepatic HSA can result in fatal hypovolemic shock due to intraperitoneal hemorrhage [2], while HSA in the right auricle or right atrium can cause cardiac tamponade, leading to fatal restrictive shock [18]. Except for HSA localized to the skin [17], canine HSA shows high recurrence and distant metastatic rates, and the biological behavior of these tumors is generally poor [12]. ...
... DOX is the standard chemotherapeutic adjuvant agent used in dogs with HSA after splenectomy [8]. Survival in dogs with viscera [12] and cardiac [18] HSA was significantly longer in those treated with surgery plus adjuvant DOX compared with those treated with surgery alone. However, there have been no reports on the efficacy of adjuvant DOX after surgery in dogs with RPHSA. ...
Retroperitoneal hemangiosarcoma (RPHSA) is a rare tumor in dogs with a poorly understood prognosis after surgery. The objectives of this study were to investigate the clinical features and prognosis of canine RPHSA that had undergone surgical resection. In this single-center, retrospective cohort study, we reviewed the medical records of dogs that had undergone surgical resection for retroperitoneal tumors and received a histopathologic diagnosis of HSA between 2005 and 2021. The median progression-free survival (PFS) and overall survival (OS) were 77.5 days and 168 days, respectively. In the present study, canine RPHSA had an aggressive biological behavior similar to visceral HSA. Further studies in larger canine populations are needed to evaluate the efficacy of adjuvant chemotherapy.
... 69The significant differences in age (and non-significant differences in OST) we observed between German Shepherds (which were younger and had shorter survival times), golden retrievers and Labrador retrievers (which were older and had longer survival times) also point to the potential influence of the genetic background. Because these three breeds have different average lifespans, it is difficult to ascertain whether German Shepherds (mean lifespan of 10.3 years) age more rapidly compared to Golden retrievers (mean lifespan 12 years) and Labrador retrievers (mean lifespan 12.6 years),[70][71][72] or if instead they age at the same rate, but their strong predisposition to HSA[70][71][72][73] and tendency towards shorter OST depress the breed's overall average survival. As Golden retrievers and Labrador retrievers also have a high HSA risk, differences in genetic background and aging may be playing a role. ...
... 69The significant differences in age (and non-significant differences in OST) we observed between German Shepherds (which were younger and had shorter survival times), golden retrievers and Labrador retrievers (which were older and had longer survival times) also point to the potential influence of the genetic background. Because these three breeds have different average lifespans, it is difficult to ascertain whether German Shepherds (mean lifespan of 10.3 years) age more rapidly compared to Golden retrievers (mean lifespan 12 years) and Labrador retrievers (mean lifespan 12.6 years),[70][71][72] or if instead they age at the same rate, but their strong predisposition to HSA[70][71][72][73] and tendency towards shorter OST depress the breed's overall average survival. As Golden retrievers and Labrador retrievers also have a high HSA risk, differences in genetic background and aging may be playing a role. ...
Canine hemangiosarcoma (HSA) is an aggressive cancer of endothelial cells with short survival times. Understanding the genomic landscape of HSA may aid in developing therapeutic strategies for dogs and may also inform therapies for the rare and aggressive human cancer angiosarcoma. The objectives of this study were to build a framework for leveraging real‐world genomic and clinical data that could provide the foundation for precision medicine in veterinary oncology, and to determine the relationships between genomic and clinical features in canine splenic HSA. One hundred and nine dogs with primary splenic HSA treated by splenectomy that had tumour sequencing via the FidoCure® Precision Medicine Platform targeted sequencing panel were enrolled. Patient signalment, weight, metastasis at diagnosis and overall survival time were retrospectively evaluated. The incidence of genomic alterations in individual genes and their relationship to patient variables including outcome were assessed. Somatic mutations in TP53 ( n = 44), NRAS ( n = 20) and PIK3CA ( n = 19) were most common. Survival was associated with presence of metastases at diagnosis and germline variants in SETD2 and NOTCH1 . Age at diagnosis was associated with somatic NRAS mutations and breed. TP53 and PIK3CA somatic mutations were found in larger dogs, while germline SETD2 variants were found in smaller dogs. We identified both somatic mutations and germline variants associated with clinical variables including age, breed and overall survival. These genetic changes may be useful prognostic factors and provide insight into the genomic landscape of hemangiosarcoma.
... On the other hand, some papers exist on the imaging findings of intracardiac neoplasia. Yamamoto et al. (2013) summarised the ultrasonographic findings of cardiac neoplasia. Among the intracardiac neoplasia, those of right atrial origin were most prevalent, with haemangiosarcoma being most commonly diagnosed. ...
Three dogs were diagnosed with right atrial thrombosis, thought to be secondary to systemic diseases. Specifically, two cases had hyperadrenocorticism and one case was diagnosed with pancreatitis with acute renal injury. In all cases, the thrombi were found within the right atrium, necessitating a differentiation from cardiac neoplasia. In all three cases, the structures assumed to be thrombi had irregular margins with interspersed hypoechoic regions, which were later confirmed as thrombi based on the responsiveness to therapy. All three cases were prescribed with the combination of clopidogrel and rivaroxaban.The thrombi gradually disappeared after initiation of the combination therapy. Complete resolution of right atrial thrombosis was noted in each dog treated with clopidogrel and rivaroxaban. This combination therapy appears to be safe and well tolerated. Diligent observation of the echocardiographic findings and clinical course allows the diagnosis of thrombosis.
