Third-degree atrioventricular block secondary to infiltrative cardiac hemangiosarcoma in a dog

Maneval, K.L.; Karlin, Emily T; Santos, Lucas Ferraz dos; Priest, K.

doi:10.1016/j.jvc.2022.05.006

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…HSA most commonly develops in the right atrium and usually as solitary tumors; however, multiple nodulation can occur within the atrium, auricle, and adjacent tissues [ 1 , 5 , 15 , 87 , 178 , 179 , 180 ]. Less common locations include the right ventricle, left-sided heart chambers, and intraventricular septum [ 5 , 180 , 182 , 183 , 184 , 185 ].…”

Section: Cardiac Hemangiosarcomamentioning

confidence: 99%

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

Nardi

Massoco

Fonseca-Alves

et al. 2023

Cancers

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Hemangiosarcoma is a mesenchymal neoplasm originating in the endothelial cells of blood vessels; they can be classified as non-visceral and visceral types. Non-visceral hemangiosarcomas can affect the skin, subcutaneous tissues, and muscle tissues; visceral hemangiosarcomas can affect the spleen, liver, heart, lungs, kidneys, oral cavity, bones, bladder, uterus, tongue, and retroperitoneum. Among domestic species, dogs are most affected by cutaneous HSA. Cutaneous HSA represents approximately 14% of all HSA diagnosed in this species and less than 5% of dermal tumors, according to North American studies. However, Brazilian epidemiological data demonstrate a higher prevalence, which may represent 27 to 80% of all canine HSAs and 13.9% of all skin neoplasms diagnosed in this species. Cutaneous HSA most commonly affects middle-aged to elderly dogs (between 8 and 15 years old), with no gender predisposition for either the actinic or non-actinic forms. The higher prevalence of cutaneous HSA in some canine breeds is related to lower protection from solar radiation, as low skin pigmentation and hair coverage lead to greater sun exposure. Actinic changes, such as solar dermatosis, are frequent in these patients, confirming the influence of solar radiation on the development of this neoplasm. There are multiple clinical manifestations of hemangiosarcoma in canines. The diagnostic approach and staging classification of cutaneous HSAs are similar between the different subtypes. The definitive diagnosis is obtained through histopathological analysis of incisional or excisional biopsies. Cytology can be used as a presurgical screening test; however, it has little diagnostic utility in cases of HSA because there is a high risk of blood contamination and sample hemodilution. Surgery is generally the treatment of choice for dogs with localized non-visceral HSA without evidence of metastatic disease. Recently, electrochemotherapy (ECT) has emerged as an alternative therapy for the local ablative treatment of different neoplastic types; the use of radiotherapy for the treatment of dogs with cutaneous HSA is uncommon. There is greater consensus in the literature regarding the indications for adjuvant chemotherapy in subcutaneous and muscular HSA; doxorubicin is the most frequently used antineoplastic agent for subcutaneous and muscular subtypes and can be administered alone or in combination with other drugs. Other therapies include antiangiogenic therapy, photodynamic therapy, the association of chemotherapy with the metronomic dose, targeted therapies, and natural products. The benefits of these therapies are presented and discussed. In general, the prognosis of splenic and cardiac HSA is unfavorable. As a challenging neoplasm, studies of new protocols and treatment modalities are necessary to control this aggressive disease.

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Section: Cardiac Hemangiosarcomamentioning

confidence: 99%

“…Intracardiac neoformations can occur with different repercussions, with cardiogenic pulmonary edema, manifestation of murmur, or remain asymptomatic or with mild symptoms of exercise intolerance, with acute evolution and sudden death [ 178 , 182 , 184 , 185 ].…”

Section: Cardiac Hemangiosarcomamentioning

confidence: 99%

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

Nardi

Massoco

Fonseca-Alves

et al. 2023

Cancers

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“…14 One case details a dog with infiltrative hemangiosarcoma in the interatrial and interventricular septum at the level of the AV node, leading to third-degree AV block. 15 The dog in this report presented with a high-grade, second-degree 4:1 AV block. Direct invasion of the mass within or near the region of the AV node is likely responsible for the conduction disturbance between the atria and ventricles 16 ; however, extensive fibrosis of the myocardial tissue associated with the mass 17 or a paraneoplastic syndrome such as myocarditis (seen rarely with thymomas) 18 are also potential causes of the bradyarrhythmia.…”

Section: Discussionmentioning

confidence: 80%

Second degree AV block in a dog with cardiac hemangiosarcoma in the interventricular septum

Margiotta,

Sammarco,

Flores

2023

Vet Record Case Reports

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A 13‐year‐old, male, neutered Maltese presented for lethargy and anorexia. Clinical examination identified bradycardia and a grade 2/6 systolic left basilar murmur. A six‐lead electrocardiogram revealed high‐degree, 4:1 second‐degree atrioventricular block, with a rate of 40 beats per minute. Echocardiography revealed a large mass in the interventricular septum, an atypical location for a cardiac mass, as a potential cause of the arrhythmia. An epicardial pacemaker was placed and a mass within pericardium was biopsied. Histopathology revealed hemangiosarcoma. The patient was treated with chemotherapy and radiation therapy and was euthanased 2 months following diagnosis.

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“…35 Conduction fibre disruptions have not been reported in TMT secondary to protein infiltration, storage disease or oedema. 28,34,[36][37][38][39] Finally, but not least, syncope can occur in the presence of severe structural heart disease. 28,34,[36][37][38] In addition to the possible association of the HCM phenotype with infiltrative neoplasia, this case report highlights the potential survival time for cats with large cell lymphoma being treated with a CMOP protocol.…”

Section: Discussionmentioning

confidence: 99%

“…The current hypothesis of TMT‐induced syncope is that infiltrative cells, such as lymphocytes, disrupt conduction fibres within the myocardium, causing arrhythmias 35 . Conduction fibre disruptions have not been reported in TMT secondary to protein infiltration, storage disease or oedema 28,34,36–39 . Finally, but not least, syncope can occur in the presence of severe structural heart disease 28,34,36–38 …”

Section: Discussionmentioning

confidence: 99%

Resolution of HCM phenotype and CHF following CMOP protocol in a cat with large cell lymphoma and suspected cardiac involvement

Herbert¹,

Todd²,

Leeder³

2022

Vet Record Case Reports

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A 10‐year‐old female desexed domestic shorthair cat was diagnosed by the regular veterinarian with large cell splenic lymphoma in June 2020. A splenectomy was performed; however, complications postoperatively and the owner's willingness to pursue chemotherapy resulted in the patient being referred to the oncology department of a local multidisciplinary specialist hospital. At referral, a hypertrophic cardiomyopathy (HCM) phenotype was diagnosed post an episode of dyspnea. The patient was treated with CMOP (cyclophosphamide, mitoxantrone, vincristine and prednisone) chemotherapy, resulting in remission of the lymphoma and the HCM phenotype. Twenty‐one months out from treatment, the patient was still in remission with no evidence of heart disease.

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Third-degree atrioventricular block secondary to infiltrative cardiac hemangiosarcoma in a dog

Cited by 4 publications

References 10 publications

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

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

Second degree AV block in a dog with cardiac hemangiosarcoma in the interventricular septum

Resolution of HCM phenotype and CHF following CMOP protocol in a cat with large cell lymphoma and suspected cardiac involvement

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