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Hemangiosarcoma^[1] is a rapidly growing, highly invasive variety of cancer, occurring almost exclusively in dogs and rarely in cats. It is a sarcoma arising from the lining of blood vessels; that is, blood-filled channels and spaces are commonly observed microscopically. A frequent cause of death is the rupturing of this tumor, causing the patient to rapidly bleed to death.

The term angiosarcoma, when used without modifier, usually refers to hemangiosarcoma. However, glomangiosarcoma (8710/3) and lymphangiosarcoma (9170/3) are distinct conditions. Hemangiosarcomas are commonly associated with toxic exposure to thorium dioxide (Thorotrast), vinyl chloride, and arsenic.

Hemangiosarcoma in dogs

Hemangiosarcoma of the skin in a dog

Hemangiosarcoma of the spleen in a dog

Hemangiosarcoma is quite common in dogs, and more so in certain breeds of dogs including German Shepherd Dogs and Golden Retrievers.^[2] It also occurs in cats, but is much rarer. Dogs with hemangiosarcoma rarely show clinical signs until the tumor has become very large and has metastasized. Typically, clinical signs are due to hypovolemia after the tumor ruptures, causing extensive bleeding. Owners of the affected dogs often discover that the dog has hemangiosarcoma only after the dog collapses.

The tumor most often appears on the spleen, right heart base, or liver, although varieties also appear on or under the skin or in other locations. It is the most common tumor of the heart, and occurs in the right atrium. Here it can cause right-sided heart failure, arrhythmias, pericardial effusion, and cardiac tamponade. Hemangiosarcoma of the spleen or liver is the most common tumor to cause hemorrhage in the abdomen.^[3] Hemangiosarcoma of the skin usually appears as a small red or bluish-black lump. It can also occur under the skin. It is suspected that in the skin, hemangiosarcoma is caused by sun exposure.^[3] Occasionally, hemangiosarcoma of the skin can be a metastasis from visceral hemangiosarcoma. Other sites the tumor may occur include bone, the kidney, the bladder, muscle, the mouth, and the central nervous system.

Clinical features

Presenting complaints and clinical signs are usually related to the site of origin of the primary tumor or to the presence of metastases, spontaneous tumor rupture, coagulopathies, or cardiac arrhythmias. More than 50% of patients are presented because of acute collapse after spontaneous rupture of the primary tumor or its metastases. Some episodes of collapse are a result of ventricular arrhythmias, which are relatively common in dogs with splenic or cardiac HSA.^[4]

Most common clinical signs of visceral hemangiosarcoma include loss of appetite, arrhythmias, weight loss, weakness, lethargy, collapse, pale mucous membranes, and/or sudden death. An enlarged abdomen is often seen due to hemorrhage. Metastasis is most commonly to the liver, omentum, lungs, or brain.

A retrospective study published in 1999 by Ware, et al., found a five times greater risk of cardiac hemangiosarcoma in spayed vs. intact female dogs and a 2.4 times greater risk of hemangiosarcoma in neutered dogs as compared to intact males.

Clinicopathologic findings

Hemangiosarcoma can cause anemia, thrombocytopenia (low platelet count), and disseminated intravascular coagulation (DIC).

HSAs usually cause a wide variety of hematologic and hemostatic abnormalities, including anemia; thrombocytopenia; presence of nRBC, schistocytes, and acanthocytes in the blood smear; and leukocytosis with neutrophilia, left shift, and monocytosis.

A definitive diagnosis requires biopsy and histopathology.

Treatments

Treatment includes chemotherapy and, where practical, removal of the tumor with the affected organ, such as with a splenectomy. Splenectomy alone gives an average survival time of 1–3 months. The addition of chemotherapy, primarily consisting of the drug doxorubicin, alone or in combination with other drugs, can increase the average survival time to 5–7 months.

Visceral hemangiosarcoma is usually fatal even with treatment, and usually within weeks or, at best, months. In the skin, it can be cured in most cases with complete surgical removal as long as there is not visceral involvement.^[3]

Herbal medicines have been adopted by certain holistic veterinary practitioners and oncologists in combination with conventional chemotherapy or alternatively when surgery or chemotherapy are not suitable.

References

^ American Kennel Club Canine Health Foundation. Accessed 2012-12-06
^ Ettinger, Stephen J.;Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine (4th ed.). W.B. Saunders Company. ISBN 0-7216-6795-3.
^ ^a ^b ^c Morrison, Wallace B. (1998). Cancer in Dogs and Cats (1st ed.). Williams and Wilkins. ISBN 0-683-06105-4.
^ Nelson et al. Manual of Small Animal Internal Medicine. Elsevier Mosby: St. Louis, Missouri (2005)

External links

Compound Derived From a Mushroom Lengthens Survival Time in Dogs With Cancer, Penn Vet Study Finds
Hemangiosarcoma research at the Modiano Lab of the Univ. of Minnesota - includes links to other canine cancer research
Vetinfo on Hemangiosarcoma
Canine Cancer Awareness on Hemangiosarcoma, including more links to current studies
Flat-Coated Retriever Hemangiosarcoma page
Vet Corner on Hemangiosarcoma
Mar Vista Animal Medical Center on Hemangiosarcoma
Hemangiosarcoma in Cats and Dogs from Pet Cancer Center
Heart hemangiosarcoma in Cats and Dogs from Pet Cancer Center

UpToDate Contents

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1. 転移性軟部組織肉腫の全身治療 systemic treatment of metastatic soft tissue sarcoma?detectedLanguage=en&source=search_result&translation=hemangiosarcoma&search=hemangiosarcoma&selectedTitle=1%7E49&provider=medicamap
2. 乳房肉腫：治療 breast sarcoma treatment?detectedLanguage=en&source=search_result&translation=hemangiosarcoma&search=hemangiosarcoma&selectedTitle=2%7E49&provider=medicamap
3. 軟部組織肉腫の臨床所見、病理組織学的検査、診断的評価、および病期分類 clinical presentation histopathology diagnostic evaluation and staging of soft tissue sarcoma?detectedLanguage=en&source=search_result&translation=hemangiosarcoma&search=hemangiosarcoma&selectedTitle=3%7E49&provider=medicamap
4. 頭頸部肉腫 head and neck sarcomas?detectedLanguage=en&source=search_result&translation=hemangiosarcoma&search=hemangiosarcoma&selectedTitle=4%7E49&provider=medicamap
5. 乳房肉腫：疫学、危険因子、臨床症状、診断、およびステージング breast sarcoma epidemiology risk factors clinical presentation diagnosis and staging?detectedLanguage=en&source=search_result&translation=hemangiosarcoma&search=hemangiosarcoma&selectedTitle=5%7E49&provider=medicamap

English Journal

Immunohistochemical detection of a potential molecular therapeutic target for canine hemangiosarcoma.

Adachi M1, Hoshino Y, Izumi Y, Takagi S.
The Journal of veterinary medical science / the Japanese Society of Veterinary Science.J Vet Med Sci.2015 Dec 21. [Epub ahead of print]
Canine hemangiosarcoma (HSA) is a progressive malignant neoplasm of dogs for which there is currently no effective treatment. A recent study suggested that receptor tyrosine kinases (RTKs), the PI3K/Akt/m-TOR and MAPK pathways are all activated in canine and human HSA. The aim of the present study w
PMID 26685984

Cytological diagnosis of cardiac masses with ultrasound guided fine needle aspirates.

Pedro B1, Linney C2, Navarro-Cubas X3, Stephenson H4, Dukes-McEwan J3, Gelzer AR3, Kraus MS3.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology.J Vet Cardiol.2015 Dec 9. pii: S1760-2734(15)00085-5. doi: 10.1016/j.jvc.2015.09.002. [Epub ahead of print]
BACKGROUND: Cardiac masses are uncommon in the canine population. When present, an attempt should be made to obtain a definitive diagnosis. Our goal with this case series was to report that as long as anatomic location permits, obtaining fine needle aspirates (FNAs) for cytological evaluation is pra
PMID 26683157

Clinical usefulness of post-operative 18F-fluorodeoxyglucose positron emission tomography-computed tomography in canine hemangiosarcoma.

Lee G1, Kwon SY2, Son K1, Park S1, Lee JH3, Cho KO1, Min JJ2, Choi J1.
Journal of veterinary science.J Vet Sci.2015 Dec 8. [Epub ahead of print]
This report describes the usefulness of positron emission tomography- computed tomography 1 (PET-CT) in evaluating recurrent or residual tumor following surgery. CT and 18F-2 fluorodeoxyglucose PET-CT were pre- and post-operatively applied to multiple masses in a 3 dog with hemangiosarcoma. The dist
PMID 26645332

Japanese Journal

腫瘍症例と健常犬における血液検査所見の比較検討

動物臨床医学 23(2), 59-65, 2016
NAID 130005125167

Evaluation of potential activity of luseogliflozin on vascular proliferation in the mesenteric lymph node with or without vascular tumors in Sprague-Dawley rats in a carcinogenicity study

Journal of Toxicologic Pathology advpub(0), 2016
NAID 130005119550

Diagnosis of a large splenic tumor in a dog : computed tomography versus magnetic resonance imaging

The journal of veterinary medical science 77(12), 1685-1687, 2015-12
NAID 40020708681

Related Pictures

★リンクテーブル★

リンク元

「血管肉腫」

Hemangiosarcoma
Classification and external resources
ICD-9-CM	155, others
ICD-O	9120/3
MeSH	D006394

　　[★]

英: angiosarcoma, hemangiosarcoma
同: 悪性血管内皮腫 malignant hemangioendothelioma、悪性脈管内皮細胞腫 malignant angioendothelioma
関: 血管形成肉腫。悪性血管外皮腫 malignant hemangiopericytoma。軟部腫瘍。Stewart-Treves症候群

肉腫に分類される。
悪性血管内皮腫と悪性血管外皮腫を指す場合があるが、多くは前者
血管あるいはリンパ管の内皮細胞の増殖による悪性腫瘍。
好発部位は皮膚(頭頚部、下肢、体幹など)、軟部組織、乳房、内臓(肝、脾など→肝血管肉腫)、骨である。
高齢者に好発する。性差は無いと言われている(BPT.397)
軟部腫瘍の1-2%のまれな腫瘍
外観上は不明瞭は暗赤紫色の紅斑と血疱をなし、易出血性隆起性の局面も認める。
組織学的には、分化型では異型内皮細胞が単層、または多層の配列を示して増殖し、不規則に吻合する小血管腔を形成する(血管腫にたような病理像を取るものをhemangiosarcomaという)が、未分化型では明らかな血管内腔を認めず、未熟な異型内皮細胞の均一性、充実性の増殖をみる(癌腫や悪性黒色腫との判別が困難)。
診断は病歴、視診から診断できるが、確定診断には生検を要する。
治療は局所切除であるが、放射線や化学療法も組み合わせられる。
血行転移しやすい。肝臓やリンパ節などのほか肺にも転移しやすく、血気胸を呈し予後はきわめて不良。
局所再発率が高く、転移率も高いので予後は不良である。
初診時から死亡までの平均生存期間は約1年で、5年生存率は数%である。

鑑別

病理

国試

103D047、112A022

[1] American Kennel Club Canine Health Foundation. Accessed 2012-12-06

[Ettinger_1995-2] Ettinger, Stephen J.;Feldman, Edward C. (1995). Textbook of Veterinary Internal Medicine (4th ed.). W.B. Saunders Company. ISBN 0-7216-6795-3.

[Morrison_1998-3] Morrison, Wallace B. (1998). Cancer in Dogs and Cats (1st ed.). Williams and Wilkins. ISBN 0-683-06105-4.

[4] Nelson et al. Manual of Small Animal Internal Medicine. Elsevier Mosby: St. Louis, Missouri (2005)

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案内

案内

hemangiosarcoma