Ch. 72: MSK neoplasia & limb spare

Question 1

Wustefeld-Janssens Vet Sx 2018

Modification of the metal endoprosthesis limb-salvage procedure for excision of a large distal radial OSA in a dog: A case report

plate and screws?
adjunct fixation?
outcome? lameness?

Answer 1

2nd generation VOI endoprosthesis & stabilized with 16 mm wide locking VOI limb-salvage plate to stabilize

3.5 mm SOP was used as adjunct fixation

The postop functional outcome was acceptable; ambulation was normal, with mild subjective lameness on treated limb at examinations 20, 43, & 63 days after surgery. Euthanized at 92d post-op for metastatic dz.

Question 2

Seguin Vet Sx 2019

Lateral manus translation for limb-sparing surgery in 18 dogs with distal radial OSA in dogs

method?
complications?
limb function?

Answer 2

Manus translated laterally to place radial carpal bone in contact with the distal aspect of the ulna

Complications developed in 12 limbs, with infection in 10, biomechanical complications in 6, & local recurrence in 4

Limb fxn was subjectively assessed as acceptable

Question 3

Hans Vet Sx 2018

Effect of SSI on survival after limb amputation in the curative-intent treatment of canine appendicular OSA: a VSSO retrospective study

median DFI?
MST?
conclusion?

Answer 3

The median DFI of dogs with SSI (292d) did not differ from that of dogs without SSI (224d)

The MST of dogs with SSI (292d) did not differ from that of dogs without SSI

Conclusion: the extended survival associated with SSI after limb-spare of OSA is not present after amputation

Question 4

Santamaria JAVMA 2019

Adverse events and outcomes in dogs with appendicular OSA treated with limb amputation and a single SQ infusion of carboplatin

MST? DFI?
% hospitalized d/t chemo?

Answer 4

MST was 196d; metastasis-free interval was 197d

3/45 (7%) dogs required hospitalization for GI signs related to chemotherapy. No chemo related deaths.

Question 5

Carloni JVIM 2019

Prevalence, distribution & clinical characteristics of HSA-associated skeletal muscle metastasis in 61 dogs: a whole body CT study

% w/ muscle mets?
male vs. female?

Answer 5

Skeletal muscle metastases were detected in 15 dogs (25%) and all of these dogs had also mets in > 1 sites

Presence of SMMs was significantly higher in males

Question 6

Jones JAVMA 2020

Radiographic features of histologically benign bone infarcts and bone infarcts associated with neoplasia in dogs

% medullary lysis?
% aggressive periosteal proliferation?

Answer 6

100% malignancy-associated lesions had aggressive medullary lysis, 23/33 (70%) benign lesions also did

8/16 (50%) malignancy-associated infarcts had aggressive periosteal proliferation, compared with 7/33 (21%) benign bone infarcts

Question 7

Giuffrida Vet Sx 2018

Primary appendicular hemangiosarcoma and telangiectatic OSA in 70n dogs: a VSSO retrospective study

MST?
what 2 things associated with longer survival for HSA?

Answer 7

Dogs with HSA were more likely than dogs with tOSA to be male & have hindlimb tumors; 78% of HSA occurred in HL especially the tibia

Dogs with tOSA weighed a median of 9.9kg more than dogs with HSA

Overall survival with local treatment and chemo was 299 d for HSA and 213 d for tOSA

Younger age & more aggressive tx were associated with longer survival in dogs with HSA but not tOSA

Question 8

Parachini-Winter JVIM 2019

Cutaneous and SQ metastasis of appendicular OSA in dogs: 20 cases

• % with CSM?
• MST sx, sx + chemo, nothing?
• Overall Px?

Answer 8

19 dogs (95%), CSM incidental finding

Median CSM ST was significantly longer for dogs tx with surgery + chemo (94d) or chemo alone (64d) than for dogs that didn’t receive these treatments (11d)

After CSM diagnosis, the prognosis is grave with median survival <2 months (might have bias - case selection)

Question 9

Kalamaras Vet Sx 2020

Impact of microwave ablation treatment on the biomechanical properties of the distal radius in the dog

Answer 9

Recorded surface temperature >100 celcius for all ablated bones
All radii failed transversely at the middle bending point
The mean peak loads for the control group and MWA group were 1641.9 N and 1590.9 N, respectively.
Stiffness 938N and 865.6N
Microwave ablation-treated radii were not biomechanically inferior to control radii (P < .0001).
Too high of surface temperatures to be clinically acceptable, but the bone wasn’t altered biomechanically, so clinically acceptable levels are probably better
In real life, vasculature helps dissipate heat

Question 10

Salyer Vet Sx 2020

Evaluation of microwave ablation for local treatment of dogs with distal radial osteosarcoma

Answer 10

Six dogs underwent MWA of distal radius OSA.
A lower power setting (30 W) was selected for the first two dogs to avoid collateral soft tissue damage.
The power was increased to 75 W for the last four dogs.
The temperature was maintained between 45C and 55C (113 F-131 F) at the bone/soft tissue interface.
All dogs were weight bearing lame after MWA and had mild soft tissue swelling and minimal exudate on the bandage
Tumor necrosis varied between 30% and 90% (median, 55%) according to histopathology.
Median 55%
No intraoperative or periprocedural complications were observed.

Question 11

Dornbusch Vet Sx 2020

Percutaneous microwave ablation of solitary presumptive pulmonary metastases in two dogs with appendicular osteosarcoma

Answer 11

Microwave ablation tip was either ultrasound or CT guided
Attempted to pass the probe through healthy parenchyma prior to entering the lesion
100W for 90 seconds dog 1 and 50W in five separate sessions (10 minutes, 8 min, 2 min, 1 min, and 1 min)
Pneumothorax requiring treatment only complication in 1 patient
82 and 19 days died/euthanized following procedure