Hemangiosarcoma

Question 1

What dogs are most commonly affected by hemangiosarcoma?

Answer 1

• GSDs
• Golden Retrievers
• Labrador Retrievers

Question 2

What organ is most commonly affected by hemangiosarcoma? What are 4 others?

Answer 2

spleen

1. right atrium + auricle
2. liver
3. retroperitoneal space
4. SQ tissue

Question 3

How do most cases of hemangiosarcoma present?

Answer 3

emergency for acute hemoabdomen and hypovolemic shock or pericardial effusion and cardiogenic shock

• history of good and bad days common, associated with bouts of internal hemorrhaging and reabsorption of the blood

Question 4

How do most splenic hemangiosarcomas appear on ultrasound? What is another benefit to this method of diagnosis?

Answer 4

cavitary and fluid filled

can also identify free abdominal fluids and metastatic lesions (liver, LNs, serosal surfaces)

Question 5

Is a FNA a common diagnostic for splenic hemangiosarcomas?

Answer 5

no - often unrewarding due to sample contamination with blood + poor exfoliation

Question 6

What surgery is performed in the treatment/biopsy of splenic hemangiosarcoma?

Answer 6

splenectomy

• avoids chance of rupturing and resulting hemorrhage seen with incisional biopsies

Question 7

What is the purpose of performing a thoracic radiograph and cardiac ultrasound in cases of hemangiosarcoma?

Answer 7

to identify pulmonary and cardiac metastasis/effusion

Question 8

What is the purpose of performing a CT or MRI in cases of hemangiosarcoma?

Answer 8

surgical planning to identify if SQ space or retroperitoneal space are involved

Question 9

What is the most common finding on CBC and blood smear in cases of hemangiosarcoma?

Answer 9

• anemia (with or without regenerative response)
• thrombocytopenia
• schistocytes

Question 10

What is the purpose of performing a coagulation panel in cases of hemangiosarcoma?

Answer 10

• prolonged clotting times can indicate DIC
• rule out rodenticide toxicity for questionable cases of hemoabdomen

Question 11

What are 3 parts to treatment of hemangiosarcoma?

Answer 11

1. resuscitate and stabilize with IV fludis and blood products
2. exploratory surgery to remove primary tumor and biopsy abnormal tissues
3. Adriamycin-based chemotherapy to delay development of metastasis and prolong survival

Question 12

What is prognosis for splenic hemangiosarcoma?

Answer 12

• surgery = 3 weeks-3 months
• Stage I (single lesion without hemorrhage) + surgery + chemotherapy = 9 months
• Stage II (single lesions with hemorrhage) + surgery + chemotherapy = 5-6 months
• Stage III (metastasis) + chemotherapy = 3.5 months

rarely makes it to a year

Question 13

Other than splenic, what is another form of hemangiosarcoma in dogs? What induces its development?

Answer 13

cutaneous

sun exposure

Question 14

What dogs are predisposed to developing cutaneous hemangiosarcoma?

Answer 14

breeds with unpigmented skin and white/thin haircoats and high sun exposure

• Pit Bulls
• Whippets
• Dalmations
• English Pointers

Question 15

What is the most commonly affected site of cutaneous hemangiosarcoma?

Answer 15

ventral abdomen and medial thighs –> sparsely haired

• all sun-exposed areas have the potential to undergo malignant transformation

Question 16

How does the behavior of cutaneous hemangiosarcoma compare to splenic hemangiosarcoma?

Answer 16

about 1/3 may metastasize and are more likely associated with advances, invasive forms of disease

Question 17

How is cutaneous hemangiosarcoma treated? Prevented? What is prognosis like?

Answer 17

surgery to remove invasive or problematic (bleeding/infected) lesions

apply sunblock or keep dogs indoors during intense sunlight hours

good - many live for years, new tumors will form since all of the affected skin in abnormal