Metastatic Cardiac Hemangiosarcoma in a 6 Year Old Wheaten Terrier Mix

Abstract

A 6 year old Wheaten Terrier mix with a history of collapse and lethargy was referred for evaluation of pericardial effusion. The echocardiogram identified pericardial effusion and a right auricular mass. No sign of metastasis was noted at this time in thoracic radiographs and abdominal ultrasounds. The patient underwent the right auriculectomy via right lateral thoracotomy. Several metastatic masses were located in the visceral aspect of the pericardium at the time of surgery and were all excised. The right auricular mass and pericardial masses were diagnosed as hemangiosarcoma with a sign of metastasis. The patient recovered from surgery uneventfully and was discharged the sixth day after surgery. The patient received doxorubicin followed by cyclophosphamide, piroxicam and Coriolus versicolor extract postoperatively. Pulmonary metastases were noted 229 days and the dog was euthanized 318 days after surgery. No clinical signs were noted until 309 days postoperatively.

Diagnosis, Prognosis, and Treatment of Canine Hemangiosarcoma: A Review Based on a Consensus Organized by the Brazilian Association of Veterinary Oncology, ABROVET

“…The clinical signs of affected animals include lethargy, apathy, anorexia, weakness, weight loss, emesis, exercise intolerance, dyspnea, cough, syncope, and collapse [ 15 , 28 , 178 , 179 , 180 , 183 , 188 , 189 , 190 , 191 ]. Physical examination revealed muffled cardiac and pulmonary auscultation, arrhythmias, weak pulse, jugular distention, pale mucous membranes, abdominal distension, dehydration, tachypnea, and tachycardia [ 5 , 15 , 28 , 179 , 180 , 189 , 190 ].…”

“…Patients complaining of pericardial effusion should undergo pericardiocentesis as the first intervention to allow for patient stabilization in addition to assisting in the diagnostic investigation, especially in cases that progress to metastasis in the pericardium. However, drainage of pericardial effusion has palliative purposes, and in the absence of definitive treatment, it becomes recurrent [ 15 , 178 , 187 , 191 ].…”

Surgical Resection of Cardiac Hemangiosarcoma Using Articulated Surgical Stapler in a Dog

“…However, several studies have shown that surgical resection alone can provide an MST of 42-86 days, whereas surgery with chemotherapy can increase MST to 116-189 days (11,19,21). In cases where incomplete resection or metastasis is present, the addition of chemotherapy can still provide a significant increase in survival time, with a reported survival time of 177 and 318 days, respectively (1,4). These findings demonstrate the benefits of surgical resection and chemotherapy in the treatment of cardiac HSA.…”

“…However, pericardiectomy alone does not prolong survival (15). Studies have shown that adjuvant chemotherapy with doxorubicin after tumor removal significantly increases the median survival time in dogs with cHSA, with reported survival times of up to 318 days after right atrial mass resection and chemotherapy (1,11,21).…”

Canine Hemangiosarcoma: A Certainly Less Than Ideal, Very Ugly Cancer

“…It wasn't until surgical exploration that several metastatic masses were seen in the pericardium and were also removed. 16 Another case study revealed a similar pattern of nonspecific gastrointestinal symptoms with no apparent cause in a daschund with primary colonic HSA24. Following two previous visits, each of which consisted of diagnostic screenings with no significant findings reported either time, the patient represented in critical condition with decreased mobility, increased melena and hematochezia, pale mucous membranes and weak femoral pulses.…”